Healthcare Provider Details

I. General information

NPI: 1548935406
Provider Name (Legal Business Name): ASHLEIGH BENNETT CHRISTIAN COUNSELOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2021
Last Update Date: 08/12/2021
Certification Date: 08/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5403 CANYON FOREST DR
HOUSTON TX
77088-2710
US

IV. Provider business mailing address

13039 CHATFIELD MANOR LN
TOMBALL TX
77377-7299
US

V. Phone/Fax

Practice location:
  • Phone: 713-550-3479
  • Fax:
Mailing address:
  • Phone: 713-550-3479
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: