Provider Demographics
NPI:1760860118
Name:LAS COLINAS PSYCHOLOGICAL SERVICES
Entity type:Organization
Organization Name:LAS COLINAS PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:NOVINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:214-310-0346
Mailing Address - Street 1:222 LAS COLINAS BLVD W
Mailing Address - Street 2:SUITE 1650 E
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-5421
Mailing Address - Country:US
Mailing Address - Phone:214-310-0346
Mailing Address - Fax:214-310-0346
Practice Address - Street 1:222 LAS COLINAS BLVD W
Practice Address - Street 2:SUITE 1650 E
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-5421
Practice Address - Country:US
Practice Address - Phone:214-310-0346
Practice Address - Fax:214-310-0346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-18
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty