Active NPI
Takisha Lagail Thibodeaux, LPC
- Professional Counselor
- Sugar Land, TX
National Provider Identifier
1336897420
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 84052
- Practice address
- 15500 Voss Rd Ste 619
Sugar Land, TX 77498-4601 - Phone
- (281) 656-1719
- NPI assigned
- Mar 16, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 84052 | TX | Primary |
Addresses
Primary practice location
15500 Voss Rd Ste 619
Sugar Land, TX 77498-4601
Mailing address
4642 Ridgerod LN
Houston, TX 77053-4748
Phone (281) 690-1485
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 84052 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647388800000",
"number": "1336897420",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4642 RIDGEROD LN",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770534748",
"telephone_number": "281-690-1485"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15500 VOSS RD STE 619",
"city": "SUGAR LAND",
"state": "TX",
"postal_code": "774984601",
"telephone_number": "281-656-1719"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THIBODEAUX",
"first_name": "TAKISHA",
"middle_name": "LAGAIL",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-16",
"last_updated": "2022-03-16",
"certification_date": "2022-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "84052",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sugar Land, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.