Provider Demographics
NPI:1992036453
Name:RIDDLE, DAPHNE L (MS, LPC, NCC)
Entity Type:Individual
Prefix:MS
First Name:DAPHNE
Middle Name:L
Last Name:RIDDLE
Suffix:
Gender:F
Credentials:MS, LPC, NCC
Other - Prefix:MRS
Other - First Name:DAPHNE
Other - Middle Name:RIDDLE
Other - Last Name:HOPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LPC, NCC
Mailing Address - Street 1:P.O. BOX 307
Mailing Address - Street 2:
Mailing Address - City:SANGER
Mailing Address - State:TX
Mailing Address - Zip Code:76266
Mailing Address - Country:US
Mailing Address - Phone:940-703-2940
Mailing Address - Fax:
Practice Address - Street 1:2214 EMERY STREET
Practice Address - Street 2:SUITE 510
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201
Practice Address - Country:US
Practice Address - Phone:940-240-2987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-22
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63863101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX211478703Medicaid