Provider Demographics
NPI:1679092282
Name:DUCOTE, KRISTI (MA, LPC, LCDC)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:
Last Name:DUCOTE
Suffix:
Gender:F
Credentials:MA, LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 GATEWAY BLVD STE 385
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-3546
Mailing Address - Country:US
Mailing Address - Phone:469-688-1787
Mailing Address - Fax:
Practice Address - Street 1:1701 GATEWAY BLVD STE 385
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3546
Practice Address - Country:US
Practice Address - Phone:469-688-1787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13903101YA0400X
TX73867101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)