Provider Demographics
NPI:1366507733
Name:DUCOTE, RAQUEL ANGELICA (MA, NCC, LPC)
Entity Type:Individual
Prefix:MISS
First Name:RAQUEL
Middle Name:ANGELICA
Last Name:DUCOTE
Suffix:
Gender:F
Credentials:MA, NCC, LPC
Other - Prefix:
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Mailing Address - Street 1:PO BOX 1365
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77402-1365
Mailing Address - Country:US
Mailing Address - Phone:832-259-3490
Mailing Address - Fax:713-667-3399
Practice Address - Street 1:5959 WEST LOOP S
Practice Address - Street 2:SUITE 410
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-2421
Practice Address - Country:US
Practice Address - Phone:832-259-3490
Practice Address - Fax:713-667-3399
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20338101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX180792701Medicaid