Provider Demographics
NPI:1942612726
Name:FLOURISH COUNSELING AND CONSULTATION, PLLC
Entity type:Organization
Organization Name:FLOURISH COUNSELING AND CONSULTATION, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST AND OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAMBRIA
Authorized Official - Middle Name:
Authorized Official - Last Name:KENNEDY-DOMINGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC, LCDC
Authorized Official - Phone:214-770-5335
Mailing Address - Street 1:533 W 12TH ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-6319
Mailing Address - Country:US
Mailing Address - Phone:972-755-9120
Mailing Address - Fax:
Practice Address - Street 1:533 W 12TH ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-6319
Practice Address - Country:US
Practice Address - Phone:972-755-9120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-28
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
TX69806101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty