Breakthrough Therapy of Frisco

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

53730 Issued in TX

Legal business name

BREAKTHROUGH THERAPY OF FRISCO

Practice address

2770 Main St
Suite 125
Frisco, TX 75033-4302

Phone

(469) 777-8448

NPI assigned

Oct 9, 2015

Last updated

Oct 9, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shannon Waters-Bland

Title

Owner

Phone

(817) 894-1122

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1444348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444348800000",
    "number": "1649641119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2770 MAIN ST",
            "address_2": "SUITE 125",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750334302",
            "telephone_number": "469-777-8448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2770 MAIN ST",
            "address_2": "SUITE 125",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750334302",
            "telephone_number": "469-777-8448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREAKTHROUGH THERAPY OF FRISCO",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-09",
        "last_updated": "2015-10-09",
        "status": "A",
        "authorized_official_last_name": "WATERS-BLAND",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-894-1122"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "61178",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "53730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssia Braxton, DC
• Brazilian Beauty Medspa LLC (HB Functional Health)
• Helena Brea
• Breakthrough Endeavors PLLC
• Breakthrough Mental Healthcare LLC
• Mark Bregard, DC
• Stephanie A Brennan, NP
• Amy Cornelia Brenski, MD
• Katy Diane Brett, PA-C
• Meghan Dauterive Brewer, CRNA

• Clinical Social Worker in Frisco, TX
• Providers in Frisco, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2015; 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.