Provider Demographics
NPI:1083107361
Name:CRINER, RICCI RENEE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:RICCI
Middle Name:RENEE
Last Name:CRINER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 E PARK BLVD #2211
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-5357
Mailing Address - Country:US
Mailing Address - Phone:469-508-9848
Mailing Address - Fax:254-687-2727
Practice Address - Street 1:1201 E PARK BLVD #2211
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-5357
Practice Address - Country:US
Practice Address - Phone:469-508-9848
Practice Address - Fax:254-687-2727
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-11
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11209101YP2500X, 101YA0400X
TX79318101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional