Healthcare Provider Details

I. General information

NPI: 1194594853
Provider Name (Legal Business Name): MENTAL BREAK COUNSELING SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2023
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8917 LOUETTA RD STE 312
SPRING TX
77379-6794
US

IV. Provider business mailing address

13810 CHAMPION FOREST DR STE 150
HOUSTON TX
77069-1883
US

V. Phone/Fax

Practice location:
  • Phone: 713-653-4461
  • Fax:
Mailing address:
  • Phone: 713-653-4461
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: NANCIA KING
Title or Position: LPC-
Credential:
Phone: 713-653-4461