Healthcare Provider Details

I. General information

NPI: 1881970382
Provider Name (Legal Business Name): QUALITY BEHAVIOR & HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2011
Last Update Date: 10/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12935 OLD RICHMOND RD
HOUSTON TX
77099-2246
US

IV. Provider business mailing address

12935 OLD RICHMOND RD
HOUSTON TX
77099-2246
US

V. Phone/Fax

Practice location:
  • Phone: 281-879-1728
  • Fax:
Mailing address:
  • Phone: 281-879-1728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14081
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number14081
License Number StateTX

VIII. Authorized Official

Name: CAROLINE PORTER DOTSON
Title or Position: CLINICIAN/ADMINISTRATOR
Credential: LMSW/ACP
Phone: 281-467-1013