Healthcare Provider Details

I. General information

NPI: 1740343946
Provider Name (Legal Business Name): BEACON MENTAL HEALTH & SOCIAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 03/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 WAVERLY ST SUITE 101
HOUSTON TX
77008-6760
US

IV. Provider business mailing address

5726 SAGAMORE BAY LN
RICHMOND TX
77469-7398
US

V. Phone/Fax

Practice location:
  • Phone: 832-248-4636
  • Fax: 866-804-7241
Mailing address:
  • Phone: 832-248-4636
  • Fax: 866-804-7241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number31626
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number5210
License Number StateTX

VIII. Authorized Official

Name: DR. STEVEN L. HOUSEWORTH
Title or Position: OWNER
Credential: PH.D., LMFT, LBSW
Phone: 832-248-4636