Healthcare Provider Details

I. General information

NPI: 1700340395
Provider Name (Legal Business Name): KARRIE GREENAWALT LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KAREMENA KNUDSON

II. Dates (important events)

Enumeration Date: 01/28/2019
Last Update Date: 01/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

704 N THOMPSON ST STE 189
CONROE TX
77301-2066
US

IV. Provider business mailing address

704 N THOMPSON ST STE 189
CONROE TX
77301-2066
US

V. Phone/Fax

Practice location:
  • Phone: 936-524-6650
  • Fax: 281-419-1811
Mailing address:
  • Phone: 936-524-6650
  • Fax: 281-419-1811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number13624
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: