Provider Demographics
NPI:1760010086
Name:CHEAIRS, KACIE (LPC-I)
Entity Type:Individual
Prefix:
First Name:KACIE
Middle Name:
Last Name:CHEAIRS
Suffix:
Gender:F
Credentials:LPC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1333 W MCDERMOTT DR STE 150
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-3088
Mailing Address - Country:US
Mailing Address - Phone:214-561-7445
Mailing Address - Fax:
Practice Address - Street 1:1333 W MCDERMOTT DR STE 150
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-3088
Practice Address - Country:US
Practice Address - Phone:214-561-7445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-31
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX82758101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX82758OtherPROFESSIONAL COUNSELORS BOARD