Healthcare Provider Details

I. General information

NPI: 1225814460
Provider Name (Legal Business Name): KAGED EMOTION COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2023
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9355 JOHN W ELLIOTT DR STE 25
FRISCO TX
75033-3392
US

IV. Provider business mailing address

840 SUMMERFIELD
PROSPER TX
75078-9198
US

V. Phone/Fax

Practice location:
  • Phone: 469-300-9334
  • Fax:
Mailing address:
  • Phone: 469-300-9334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KEONTA L GOLSON
Title or Position: PRESIDENT
Credential: LPC
Phone: 469-300-9334