Provider Demographics
NPI:1780171603
Name:COGNETTA, CHRIS JAMES (LPC)
Entity type:Individual
Prefix:MR
First Name:CHRIS
Middle Name:JAMES
Last Name:COGNETTA
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2030 N HASKELL AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-4216
Mailing Address - Country:US
Mailing Address - Phone:214-566-1551
Mailing Address - Fax:214-824-2488
Practice Address - Street 1:4228 N CENTRAL EXPY
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206-6548
Practice Address - Country:US
Practice Address - Phone:214-566-1551
Practice Address - Fax:214-824-2488
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-16
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70758101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty