Healthcare Provider Details

I. General information

NPI: 1144136102
Provider Name (Legal Business Name): KRISTIN RUE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 ELDORADO PKWY
MCKINNEY TX
75070-4300
US

IV. Provider business mailing address

1300 GRANGER DR
MCKINNEY TX
75071-1611
US

V. Phone/Fax

Practice location:
  • Phone: 214-945-9173
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number112960
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: