MEDICARE: GIANNI EGUAKUN 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
1	101YM0800X	Mental Health Counselor	90638	TX

General Provider Information

NPI Number	:	1649742768
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GIANNI EGUAKUN LPC

Provider Business Mailing Address
First Line	:	3618 WINGATE PARK DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77082-9001
Country	:	US
Telephone Number	:	346-432-1648
Fax Number	:

Provider Business Practice Location Address
First Line	:	5900 BALCONES DR # 23673
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78731-4257
Country	:	US
Telephone Number	:	346-432-1648
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/31/2018
Last Update Date	:	02/17/2025

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