Provider Demographics
NPI:1487333944
Name:FIVE SEASONS THERAPY PLLC
Entity type:Organization
Organization Name:FIVE SEASONS THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:PENG
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LICSW
Authorized Official - Phone:469-422-0376
Mailing Address - Street 1:945 STOCKTON DR UNIT 7100
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-6155
Mailing Address - Country:US
Mailing Address - Phone:469-422-0376
Mailing Address - Fax:
Practice Address - Street 1:945 STOCKTON DR UNIT 7100
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-6155
Practice Address - Country:US
Practice Address - Phone:469-422-0376
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty