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General NPI Number Information
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NPI Number | 1073282778
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Entity Type | Organization
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Legal Business Name | OPTIMIZE YOUR LIVING COUNSELING CENTER LLC
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Dates
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Enumeration Date | 09/07/2021
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Last Update Date | 01/20/2024
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Provider Practice Location Address
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Address Line | 16757 SQUYRES RD STE 110
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City | SPRING
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State | TX
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Zip | 77379-7294
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Country | US
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Telephone | 346-497-4116
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Fax |
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Provider Business Mailing Address
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Address Line | 20333 STATE HIGHWAY 249 STE 200
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City | HOUSTON
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State | TX
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Zip | 77070-2613
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Country | US
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Telephone | 346-235-3926
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CORNELIA JOHNSON
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Credential |
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Telephone | 346-235-3926
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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