Healthcare Provider Details

I. General information

NPI: 1871592428
Provider Name (Legal Business Name): LILLIAN MANCINI PRIEST MA. LPC-S, RPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LILLIAN MANCINI VERNON N/A

II. Dates (important events)

Enumeration Date: 07/16/2005
Last Update Date: 07/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 MASON ST COUNSELING RESOURCE CENTER
TOMBALL TX
77375-4450
US

IV. Provider business mailing address

500 MASON ST COUNSELING RESOURCE CENTER
TOMBALL TX
77375-4450
US

V. Phone/Fax

Practice location:
  • Phone: 281-255-9922
  • Fax: 281-255-9064
Mailing address:
  • Phone: 281-255-9922
  • Fax: 281-255-9064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number19192
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: