MEDICARE: MONICA TESS COULTER LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	68705	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841623923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONICA TESS COULTER LPC

Provider Business Mailing Address
First Line	:	6800 WEISKOPF AVE
Second Line	:	SUITE 150, OFFICE 104
City	:	MCKINNEY
State	:	TX
Zip	:	75070-5242
Country	:	US
Telephone Number	:	469-640-6217
Fax Number	:

Provider Business Practice Location Address
First Line	:	6800 WEISKOPF AVE
Second Line	:	SUITE 150, OFFICE 104
City	:	MCKINNEY
State	:	TX
Zip	:	75070-5242
Country	:	US
Telephone Number	:	469-640-6217
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/13/2013
Last Update Date	:	09/06/2016

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