Healthcare Provider Details

I. General information

NPI: 1568647980
Provider Name (Legal Business Name): BEHAVIORAL AND COUNSELING SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2008
Last Update Date: 01/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1110 N LOOP 336 W STE 250
CONROE TX
77301-1194
US

IV. Provider business mailing address

1092 ELKINS LK
HUNTSVILLE TX
77340-8831
US

V. Phone/Fax

Practice location:
  • Phone: 936-827-9544
  • Fax: 936-788-1010
Mailing address:
  • Phone: 936-443-4671
  • Fax: 936-788-1010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number18730
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number28964
License Number StateTX

VIII. Authorized Official

Name: SUSAN E GOOD
Title or Position: OWNER
Credential: M.A., LPC
Phone: 936-827-9544