Provider Demographics
NPI:1689263535
Name:SEMIDEY, MIA K (MS, LPC-ASSOCIATE)
Entity Type:Individual
Prefix:
First Name:MIA
Middle Name:K
Last Name:SEMIDEY
Suffix:
Gender:F
Credentials:MS, LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:732 ROBERTS ST
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76209-2118
Mailing Address - Country:US
Mailing Address - Phone:903-490-7705
Mailing Address - Fax:
Practice Address - Street 1:1421 N ELM ST STE 103
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-3055
Practice Address - Country:US
Practice Address - Phone:469-476-4491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-14
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX84983101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional