Provider Demographics
NPI:1548365075
Name:THIBEAUX, DONALD EUGENE (LCSW, LCDC)
Entity type:Individual
Prefix:MR
First Name:DONALD
Middle Name:EUGENE
Last Name:THIBEAUX
Suffix:
Gender:M
Credentials:LCSW, LCDC
Other - Prefix:
Other - First Name:DON
Other - Middle Name:
Other - Last Name:THIBEAUX
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW,LCDC
Mailing Address - Street 1:8390 LBJ FWY STE 1000
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-1288
Mailing Address - Country:US
Mailing Address - Phone:214-361-2100
Mailing Address - Fax:
Practice Address - Street 1:8390 LBJ FWY STE 1000
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-1288
Practice Address - Country:US
Practice Address - Phone:214-361-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8311101YA0400X
TX403631041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)