Mystic Maze Therapy and Consultation, PLLC

Primary specialty

CounselorTaxonomy code 101Y00000X

Legal business name

MYSTIC MAZE THERAPY AND CONSULTATION, PLLC

Practice address

1411 Taperwicke Dr
Dallas, TX 75232-4609

Phone

(469) 542-0463

NPI assigned

May 25, 2022

Organization subpart

No

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

Authorized official

Name

Veronica Frazier, LMFT, LPCNPI 1871152413

Title

Owner/Supervisor

Phone

(469) 542-0463

Specialties & licenses 2

Addresses

Practitioners 1

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

• Veronica Frazier, LMFT, LPC

  • Mental Health Counselor
  • Dallas, TX
  • NPI 1871152413
  NPD Authorized official

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

{
    "created_epoch": "1653436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659916800000",
    "number": "1740928027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 OAKBLUFF DR",
            "city": "LANCASTER",
            "state": "TX",
            "postal_code": "751461429",
            "telephone_number": "469-542-0463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 TAPERWICKE DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752324609",
            "telephone_number": "469-542-0463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYSTIC MAZE THERAPY AND CONSULTATION, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-25",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A",
        "authorized_official_last_name": "FRAZIER",
        "authorized_official_first_name": "VERONICA",
        "authorized_official_title_or_position": "OWNER/SUPERVISOR",
        "authorized_official_telephone_number": "469-542-0463",
        "authorized_official_credential": "LMFT, LPC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Myron H. Watkins, MD PA
• Myron S Lazar PHD
• Myron S. Lazar PH.D., P.C.
• Myrtle's Mo Love Home Health
• Krysten Myser, MD
• Hannah Myung, PA-C
• Abigail Mzila
• Nancy Michael Mziray-Akame, RN
• N Kopman DO PA
• N.E. Dallas Healthcare Center

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; 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.