Provider Demographics
NPI:1285007153
Name:FUTRELL, AUDREY (LPC, LCDC)
Entity Type:Individual
Prefix:
First Name:AUDREY
Middle Name:
Last Name:FUTRELL
Suffix:
Gender:F
Credentials:LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 ABRAMS RD STE 325
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-5579
Mailing Address - Country:US
Mailing Address - Phone:972-638-7199
Mailing Address - Fax:
Practice Address - Street 1:1221 ABRAMS RD STE 325
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-5579
Practice Address - Country:US
Practice Address - Phone:972-638-7199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-02
Last Update Date:2015-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12817101YA0400X
TX69730101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)