Healthcare Provider Details

I. General information

NPI: 1740001502
Provider Name (Legal Business Name): FIONA MARIE CHEYNE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2024
Last Update Date: 09/22/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23419 GRAND RESERVE DRIVE, SUITE 401
KATY TX
77494
US

IV. Provider business mailing address

23419 GRAND RESERVE DRIVE, SUITE 401
KATY TX
77494-5917
US

V. Phone/Fax

Practice location:
  • Phone: 281-519-6364
  • Fax:
Mailing address:
  • Phone: 281-519-6364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number96530
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: