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General NPI Number Information
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NPI Number | 1265809792
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Entity Type | Individual
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Provider Name | STEFANI THREADGILL LMFT-A, LPC-I, LCDC
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Gender | Female
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Dates
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Enumeration Date | 09/01/2015
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Last Update Date | 12/02/2016
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Provider Practice Location Address
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Address Line | 5851 LEGACY CIR SIXTH FLOOR, NO. 6016
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City | PLANO
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State | TX
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Zip | 75024-5966
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Country | US
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Telephone | 469-626-5253
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Fax |
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Provider Business Mailing Address
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Address Line | 6748 FIRENZE LN
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City | FRISCO
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State | TX
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Zip | 75034-4099
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Country | US
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Telephone | 214-886-4635
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 73688
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 12920
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 202441
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License Number State | TX
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