Provider Demographics
NPI:1831515477
Name:QUADRI, KHADIJAT (MA, LPC, NCC)
Entity type:Individual
Prefix:MRS
First Name:KHADIJAT
Middle Name:
Last Name:QUADRI
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 E PIEDRAS DR
Mailing Address - Street 2:262
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78228-1401
Mailing Address - Country:US
Mailing Address - Phone:210-314-7687
Mailing Address - Fax:210-314-7494
Practice Address - Street 1:4100 E PIEDRAS DR
Practice Address - Street 2:262
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78228-1401
Practice Address - Country:US
Practice Address - Phone:210-314-7687
Practice Address - Fax:210-314-7494
Is Sole Proprietor?:No
Enumeration Date:2014-03-06
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67102101YM0800X, 101YA0400X, 101Y00000X, 103K00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX332994801Medicaid