Provider Demographics
NPI:1992468680
Name:HEADLEY, NANCE' ANN (LPC)
Entity Type:Individual
Prefix:
First Name:NANCE'
Middle Name:ANN
Last Name:HEADLEY
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 1:1714 ROBERTS RAVINE RD
Mailing Address - Street 2:
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-6710
Mailing Address - Country:US
Mailing Address - Phone:972-467-0094
Mailing Address - Fax:
Practice Address - Street 1:8380 WARREN PKWY STE 602
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-4253
Practice Address - Country:US
Practice Address - Phone:972-467-0093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-19
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
TX87235101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health