Healthcare Provider Details

I. General information

NPI: 1871485185
Provider Name (Legal Business Name): SABRINA CHANTAIL ROQUEMORE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2025
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6010 W SPRING CREEK PKWY
PLANO TX
75024-3569
US

IV. Provider business mailing address

6010 W SPRING CREEK PKWY
PLANO TX
75024-3569
US

V. Phone/Fax

Practice location:
  • Phone: 972-737-8392
  • Fax:
Mailing address:
  • Phone: 972-737-8392
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number8635
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number93441
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: