Nourish Play Therapy LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

71350 Issued in TX

Legal business name

NOURISH PLAY THERAPY LLC

Practice address

5510 Abrams Rd Ste 120
Dallas, TX 75214-2099

Phone

(214) 208-7469

Fax

(866) 294-6406

NPI assigned

Jul 7, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Antoinette Marie Martinez, LPC

Title

Owner/Therapist

Phone

(214) 208-7469

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464652800000",
    "number": "1487037685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5510 ABRAMS RD STE 120",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752142099",
            "telephone_number": "214-208-7469",
            "fax_number": "866-294-6406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5510 ABRAMS RD STE 120",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752142099",
            "telephone_number": "214-208-7469",
            "fax_number": "866-294-6406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOURISH PLAY THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-07",
        "last_updated": "2016-05-31",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "ANTOINETTE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "214-208-7469",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "71350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3501587",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Blessing Dorcas Noumba Londo
• Marwan Sherif Nour Abdalla, MD
• Amal Noureldin, BDS, MS, PHD
• Farnoosh Massoudian Nouri, M.ED., LPC
• Leyla Nourian, DDS
• Nova Path Lab LLC
• Jessica M. Novak, PT, DPT
• Kelly A. Novak, AUD, CCC/A
• Georgi Novakov, CNIM, D.ABNM
• Roberta Novakovic, MD

• Professional Counselor in Dallas, TX
• Providers in Dallas, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.