=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184433864
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DUDLEY CONSULTING & COACHING SERVICES, LLC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/06/2025
-----------------------------------------------------
Last Update Date | 12/29/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 309 E AUSTIN ST STE 16
-----------------------------------------------------
City | MARSHALL
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75670-3475
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 903-330-1769
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 309 E AUSTIN ST STE 16
-----------------------------------------------------
City | MARSHALL
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75670-3475
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 903-330-1769
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MS. CRYSTAL DIONNE DUDLEY
-----------------------------------------------------
Credential | LPC
-----------------------------------------------------
Telephone | 903-330-1769
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------