NPIMap

Organization Active NPI

LDS Family Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Carrollton, TX
National Provider Identifier
1780711309
Registry record updated Jun 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
497 Issued in TX
Legal business name
LDS FAMILY SERVICES
Practice address
1100 W Jackson Rd
Carrollton, TX 75006-1316
Phone
(972) 242-2182
Fax
(972) 242-2932
NPI assigned
Feb 28, 2007
Organization subpart
Yes
Parent organization
LDS FAMILY SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 6, 2008

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

Authorized official

Name
Eric Fernelius, LCSW
Title
Director
Phone
(972) 242-2182

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 497 TX Primary

Addresses

Primary practice location

1100 W Jackson Rd
Carrollton, TX 75006-1316

Mailing address

1100 W Jackson Rd
Carrollton, TX 75006-1316
Phone (972) 242-2182

Other identifiers 1

IdentifierTypeStateIssuer
0003NFOtherTXBLUE CROSS BLUE SHIELD

Other names 1

  • LDS Family Services TX Carrollton Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Robert D Smith PHD46 organizations share this tax ID, including this one
Part of
Robert D Smith PHD

Other organizations with this tax ID 45

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

View all 45

Locations

1100 W Jackson Rd
Carrollton, TX 75006
Phone (972) 242-2182

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212710400000",
    "number": "1780711309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 W JACKSON RD",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750061316",
            "telephone_number": "972-242-2182",
            "fax_number": "972-242-2932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 W JACKSON RD",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750061316",
            "telephone_number": "972-242-2182",
            "fax_number": "972-242-2932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LDS FAMILY SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LDS FAMILY SERVICES",
        "enumeration_date": "2007-02-28",
        "last_updated": "2008-06-06",
        "status": "A",
        "authorized_official_last_name": "FERNELIUS",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "972-242-2182",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "TX",
            "license": "497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0003NF",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LDS Family Services TX Carrollton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carrollton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2008; 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.