| Southlake Therapy Group | |
|
1701 W Northwest Hwy Grapevine TX 76051-8127 | |
| (817) 290-6908 | |
| Not Available |
| Full Name | Southlake Therapy Group |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1701 W Northwest Hwy, Grapevine, Texas |
| Authorized Official Name and Position | Bailey Pittman (OWNER) |
| Authorized Official Contact | 8172906908 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southlake Therapy Group 2025 N Hill Dr Irving TX 75038-6217 Ph: () - | Southlake Therapy Group 1701 W Northwest Hwy Grapevine TX 76051-8127 Ph: (817) 290-6908 |
| NPI Number | 1275336554 |
|---|---|
| Provider Enumeration Date | 03/31/2025 |
| Last Update Date | 03/31/2025 |
| Certification Date | 03/31/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275336554 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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