Healthcare Provider Details

I. General information

NPI: 1568180586
Provider Name (Legal Business Name): JENNIFER NICOLE MEJIA LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER NICOLE OATES LPC-ASSOCIATE

II. Dates (important events)

Enumeration Date: 08/16/2022
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 SUL ROSS ST
HOUSTON TX
77006-5031
US

IV. Provider business mailing address

516 SUL ROSS ST
HOUSTON TX
77006-5031
US

V. Phone/Fax

Practice location:
  • Phone: 281-669-0755
  • Fax:
Mailing address:
  • Phone: 281-669-0755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: