Provider Demographics
NPI:1841589124
Name:STANTON, GENETTE DODSON (LPC-INTERN)
Entity Type:Individual
Prefix:MRS
First Name:GENETTE
Middle Name:DODSON
Last Name:STANTON
Suffix:
Gender:F
Credentials:LPC-INTERN
Other - Prefix:MISS
Other - First Name:LYDIA
Other - Middle Name:GENETTE
Other - Last Name:DODSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11 RAINTREE PLACE
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77381
Mailing Address - Country:US
Mailing Address - Phone:713-819-8663
Mailing Address - Fax:
Practice Address - Street 1:9595 SIX PINES DRIVE
Practice Address - Street 2:SUITE 8210
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380
Practice Address - Country:US
Practice Address - Phone:281-748-0233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65859101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional