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General NPI Number Information
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NPI Number | 1184531790
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Entity Type | Organization
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Legal Business Name | MOODLY MODERN THERAPY, PLLC
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Dates
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Enumeration Date | 08/27/2026
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Last Update Date | 09/02/2026
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Provider Practice Location Address
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Address Line | 4308 CHEETAH TRL
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City | FRISCO
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State | TX
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Zip | 75034-4112
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Country | US
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Telephone | 504-813-9863
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Fax |
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Provider Business Mailing Address
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Address Line | 4308 CHEETAH TRL
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City | FRISCO
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State | TX
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Zip | 75034-4112
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Country | US
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Telephone | 504-813-9863
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KIKI MCCRAY
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Credential | LPC-S
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Telephone | 469-443-8611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | NULL
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