| Authentic Therapy Solutions Pllc | |
|
13747 Montfort Dr Ste 230 Dallas TX 75240-4454 | |
| (214) 506-3134 | |
| Not Available |
| Full Name | Authentic Therapy Solutions Pllc |
|---|---|
| Speciality | Counselor |
| Location | 13747 Montfort Dr Ste 230, Dallas, Texas |
| Authorized Official Name and Position | Buddy Detzel (OWNER) |
| Authorized Official Contact | 2147011987 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Authentic Therapy Solutions Pllc 11846 Rupley Ln Dallas TX 75218-2068 Ph: (214) 506-3134 | Authentic Therapy Solutions Pllc 13747 Montfort Dr Ste 230 Dallas TX 75240-4454 Ph: (214) 506-3134 |
| NPI Number | 1982487302 |
|---|---|
| Provider Enumeration Date | 08/17/2023 |
| Last Update Date | 08/17/2023 |
| Certification Date | 08/17/2023 |
| Medicare PECOS PAC ID | 5395187645 |
|---|---|
| Medicare Enrollment ID | O20240531001713 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982487302 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Buddy Detzel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174977110 PECOS PAC ID: 0749622090 Enrollment ID: I20240531002018 |
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