Provider Demographics
NPI:1407293715
Name:ROUSSEAU, NANETTE (LPC)
Entity Type:Individual
Prefix:
First Name:NANETTE
Middle Name:
Last Name:ROUSSEAU
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 1:6905 CINNABAR DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-2177
Mailing Address - Country:US
Mailing Address - Phone:214-769-7831
Mailing Address - Fax:214-919-4007
Practice Address - Street 1:6905 CINNABAR DR STE 103
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-2177
Practice Address - Country:US
Practice Address - Phone:214-769-7831
Practice Address - Fax:214-919-4007
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-28
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66571101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional