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General NPI Number Information
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NPI Number | 1568861730
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Entity Type | Individual
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Provider Name | KAIESHA L. FLUCAS M.S., LPC-S, NCC
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Gender | Female
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Dates
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Enumeration Date | 08/13/2014
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Last Update Date | 05/01/2024
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Provider Practice Location Address
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Address Line | 1801 N. HAMPTON RD. STE. 425 #1338
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City | DESOTO
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State | TX
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Zip | 75115-4229
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Country | US
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Telephone | 214-960-1536
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Fax | 800-660-2523
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Provider Business Mailing Address
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Address Line | 1801 N. HAMPTON RD. STE. 425 #1338
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City | DESOTO
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State | TX
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Zip | 75115-4229
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Country | US
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Telephone | 214-960-1536
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Fax | 800-660-2523
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 70148
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License Number State | TX
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