Gifted Souls Mental Health Community Center LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

GIFTED SOULS MENTAL HEALTH COMMUNITY CENTER LLC

Practice address

17480 Dallas Pkwy Ste 213
Dallas, TX 75287-7304

Phone

(469) 510-4291

NPI assigned

Jan 19, 2021

Organization subpart

No

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

Authorized official

Name

Andre Mayo

Title

Owner

Phone

(469) 510-4291

Specialties & licenses 8

Addresses

Tax ID family

Gifted Souls Mental Health Community Center LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Gifted Souls Mental Health Community Center LLC

  • Case Management Agency
  • Dallas, TX
  • NPI 1740870005
  NPD tax ID
• Gifted Souls Mental Health Community Center LLC

  • Behavior Analyst
  • Dallas, TX
  • NPI 1821942871
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cierra Batiste, LPC

  • Mental Health Counselor
  • Dallas, TX
  • NPI 1740666452
  NPD (past)
• Priscilla Abigail Francis, LCSW

  • Clinical Social Worker
  • Houston, TX
  • NPI 1881196459
  NPD (past)

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

{
    "created_epoch": "1611014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724284800000",
    "number": "1508456047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17480 DALLAS PKWY STE 213",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752877304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17480 DALLAS PKWY STE 213",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752877304",
            "telephone_number": "469-510-4291"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1610 S Malcolm X Blvd Ste 320",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752262100",
            "country_code": "US",
            "telephone_number": "214-272-7148",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2743 Smith Ranch Rd Unit 1502",
            "address_purpose": "LOCATION",
            "city": "Pearland",
            "state": "TX",
            "postal_code": "775845204",
            "country_code": "US",
            "telephone_number": "214-272-7148",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7808 Bellfot Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770712147",
            "country_code": "US",
            "telephone_number": "214-272-7148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GIFTED SOULS MENTAL HEALTH COMMUNITY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-19",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-20",
        "status": "A",
        "authorized_official_last_name": "MAYO",
        "authorized_official_first_name": "ANDRE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "469-510-4291"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mickey Ray Gierhart, MD
• Abbye C Gieringer, OTR
• Kelly B Giesecke, OT
• Mary Kay Giesecke, MS-CCC-SLP
• William Giesing, MD
• Gifted Souls Mental Health Community Center LLC
• Gifted Souls Mental Health Community Center LLC
• Kristin Lane Giggleman, CCC-SLP
• Kristin Hittle Gigli, CPNP
• Rebecca Ann Giguere, RN

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Dallas, TX
• Providers in Dallas, TX by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; 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.