Healthcare Provider Details

I. General information

NPI: 1740144518
Provider Name (Legal Business Name): BARAKAH HASSELL LPC-ASSOCIATE
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12501 STATE HWY 185 APT 36
BLOOMINGTON TX
77951-0160
US

IV. Provider business mailing address

12501 STATE HWY 185 APT 36
BLOOMINGTON TX
77951-0160
US

V. Phone/Fax

Practice location:
  • Phone: 312-330-3899
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number97108
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: