MEDICARE: SEVERANCE INTENSIVE OUTPATIENT PROGRAM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
2	261QM1300X	Multi-Specialty Clinic/Center
3	324500000X	Substance Abuse Rehabilitation Facility
4	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1639894306	OTHER	TX	NPI

General Provider Information

NPI Number	:	1205780103
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SEVERANCE INTENSIVE OUTPATIENT PROGRAM

Provider Business Mailing Address
First Line	:	5528 HOLLY SPRINGS DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77056-2024
Country	:	US
Telephone Number	:	713-364-4155
Fax Number	:

Provider Business Practice Location Address
First Line	:	303 JACKSON HILL ST FL 2
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77007-7407
Country	:	US
Telephone Number	:	832-998-1238
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JEFF DOUGLAS COIRA
Credential	:	LCSW-S, LCDC, CST
Telephone Number	:	713-857-1832

Provider Enumeration Date	:	02/26/2026
Last Update Date	:	02/26/2026

Similar Medicare Providers

1982569463 — COURTNEY LONGWAY
Practice Location Address:

303 JACKSON HILL ST
HOUSTON, TX
77007-7407

Practice Phone: 713-364-4155
Practice Fax:

1639894306 — JEFFREY DOUGLAS COIRA LCSW-S, LCDC, CST
Practice Location Address:

303 JACKSON HILL ST FL 2
HOUSTON, TX
77007-7407

Practice Phone: 713-364-4155
Practice Fax:

1518640507 — MARIELA LISETTE CASTRO LPC
Practice Location Address:

303 JACKSON HILL ST
HOUSTON, TX
77007-7407

Practice Phone: 713-364-4155
Practice Fax:

1174569875 — MS. ELIZABETH HABERER L.C.S.W.
Practice Location Address:

303 JACKSON HILL ST , ROOM 225
HOUSTON, TX
77007-7407

Practice Phone: 281-200-9216
Practice Fax: 281-200-9170

1326071770 — LONIQUE PRITCHETT LCSW
Practice Location Address:

303 JACKSON HILL ST
HOUSTON, TX
77007-7407

Practice Phone: 281-200-9226
Practice Fax: 281-200-9170

1780617134 — THE COUNCIL ON RECOVERY
Practice Location Address:

303 JACKSON HILL ST
HOUSTON, TX
77007-7407

Practice Phone: 281-200-9120
Practice Fax: 281-200-9765

Directions to “SEVERANCE INTENSIVE OUTPATIENT PROGRAM ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.