Provider Demographics
NPI:1093457863
Name:GOLSTON, FELICIA JOY (LPC-A)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:JOY
Last Name:GOLSTON
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1814 MATAGORDA DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75232-2844
Mailing Address - Country:US
Mailing Address - Phone:214-498-6758
Mailing Address - Fax:
Practice Address - Street 1:1229 E PLEASANT RUN RD STE 205
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-4214
Practice Address - Country:US
Practice Address - Phone:469-518-6034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-11
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX87729101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health