Provider Demographics
NPI:1265809792
Name:THREADGILL, STEFANI (LMFT-A, LPC-I, LCDC)
Entity type:Individual
Prefix:
First Name:STEFANI
Middle Name:
Last Name:THREADGILL
Suffix:
Gender:F
Credentials:LMFT-A, LPC-I, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6748 FIRENZE LN
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-4099
Mailing Address - Country:US
Mailing Address - Phone:214-886-4635
Mailing Address - Fax:
Practice Address - Street 1:5851 LEGACY CIR
Practice Address - Street 2:SIXTH FLOOR, NO. 6016
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-5966
Practice Address - Country:US
Practice Address - Phone:469-626-5253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-01
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73688101Y00000X
TX12920101YA0400X
TX202441106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)