MEDICARE: MRS. RHONDA ROSHELLE MARK 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	79830	TX
2	101YP2500X	Professional Counselor	79830	TX
3	101Y00000X	Counselor	79830	TX

General Provider Information

NPI Number	:	1821681578
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. RHONDA ROSHELLE MARK LPC

Provider Business Mailing Address
First Line	:	19901 SOUTHWEST FWY STE 235
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-6538
Country	:	US
Telephone Number	:	281-504-7393
Fax Number	:

Provider Business Practice Location Address
First Line	:	19901 SOUTHWEST FWY STE 235
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-6538
Country	:	US
Telephone Number	:	281-504-7393
Fax Number	:

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

Provider Enumeration Date	:	02/13/2021
Last Update Date	:	05/22/2026

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