Provider Demographics
NPI:1801221809
Name:KREBS, MARIE (MS, LPC, LCDC, SRT)
Entity Type:Individual
Prefix:MS
First Name:MARIE
Middle Name:
Last Name:KREBS
Suffix:
Gender:F
Credentials:MS, LPC, LCDC, SRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3870 DUCHESS TRL
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75229-5241
Mailing Address - Country:US
Mailing Address - Phone:214-315-4810
Mailing Address - Fax:
Practice Address - Street 1:8215 WESTCHESTER DR STE 228
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-6116
Practice Address - Country:US
Practice Address - Phone:214-315-4810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-09
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11932101YA0400X
TX66706101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional