Healthcare Provider Details

I. General information

NPI: 1467168278
Provider Name (Legal Business Name): JONATHAN MILES HOCKEMEYER LCDC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2023
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3043 GESSNER RD
HOUSTON TX
77080-1000
US

IV. Provider business mailing address

23655 HORSESHOE BND
MONTGOMERY TX
77316-3663
US

V. Phone/Fax

Practice location:
  • Phone: 936-333-4649
  • Fax:
Mailing address:
  • Phone: 936-333-4649
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number16417
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number100974
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: