Provider Demographics
NPI:1760531552
Name:GIST, RHONDA A (LPC)
Entity Type:Individual
Prefix:MS
First Name:RHONDA
Middle Name:A
Last Name:GIST
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 1:1212 COLLIN DR
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-4104
Mailing Address - Country:US
Mailing Address - Phone:214-693-4688
Mailing Address - Fax:469-519-9482
Practice Address - Street 1:305 S JUPITER RD
Practice Address - Street 2:SUITE 110
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-3050
Practice Address - Country:US
Practice Address - Phone:972-772-8484
Practice Address - Fax:469-519-9482
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18816101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional