Healthcare Provider Details

I. General information

NPI: 1659372647
Provider Name (Legal Business Name): TIM MAVERGEORGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13333 SOUTHWEST FWY HOUSTON CENTER FOR CHRISTIAN COUNSELING SUITE# 230
SUGAR LAND TX
77478-3581
US

IV. Provider business mailing address

13333 SOUTHWEST FWY HOUSTON CENTER FOR CHRISTIAN COUNSELING SUITE# 230
SUGAR LAND TX
77478-3581
US

V. Phone/Fax

Practice location:
  • Phone: 281-277-8811
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC 04719
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT 000635-041239
License Number StateTX

VIII. Authorized Official

Name: DR. SHARON R JENKINS
Title or Position: CONTRACT THERAPIST
Credential: PHD
Phone: 281-277-8811