Healthcare Provider Details
I. General information
NPI: 1205664976
Provider Name (Legal Business Name): URGENT CARE COUNSELING CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/24/2024
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5403 CANYON FOREST DR
HOUSTON TX
77088-2710
US
IV. Provider business mailing address
12914 ORCHARD HOLLOW WAY
HOUSTON TX
77065-3332
US
V. Phone/Fax
- Phone: 713-550-3479
- Fax:
- Phone: 713-550-3479
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 102L00000X |
| Taxonomy | Psychoanalyst |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251B00000X |
| Taxonomy | Case Management Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ASHLEIGH
BENNETT
Title or Position: FOUNDER/EXECUTIVE DIRECTOR
Credential:
Phone: 713-550-3479