Healthcare Provider Details

I. General information

NPI: 1467975003
Provider Name (Legal Business Name): SIANNAN ERNESTINE LIBERTY LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2017
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22720 MORTON RANCH RD STE 160
KATY TX
77449-2155
US

IV. Provider business mailing address

9401 SOUTHWEST FWY
HOUSTON TX
77074-1407
US

V. Phone/Fax

Practice location:
  • Phone: 512-593-8744
  • Fax:
Mailing address:
  • Phone: 713-970-7000
  • Fax: 713-970-7246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number22251
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number74085
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: