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NPI Code Detail

MEDICARE: SELENIA PELLERIN LPC

MEDICARE:   SELENIA  PELLERIN  LPC
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor72954TX

General Provider Information

NPI Number : 1578227260
Entity Type Code : Individual
Provider Name (Legal Business Name) : SELENIA PELLERIN LPC
Provider Business Mailing Address
First Line : 1010 W 24TH ST UNIT L
Second Line :
City : HOUSTON
State : TX
Zip : 77008-2269
Country : US
Telephone Number : 832-724-3867
Fax Number :
Provider Business Practice Location Address
First Line : 1325 CAMPBELL RD
Second Line :
City : HOUSTON
State : TX
Zip : 77055-6403
Country : US
Telephone Number : 713-365-9015
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2021
Last Update Date : 10/28/2021

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Directions to “ SELENIA PELLERIN LPC” Practice Location

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