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General NPI Number Information
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NPI Number | 1093634107
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Entity Type | Individual
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Provider Name | AUTUMN JERIA LPC-A
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Gender | Female
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Dates
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Enumeration Date | 07/13/2026
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Last Update Date | 07/13/2026
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Provider Practice Location Address
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Address Line | 154 BELLA KATY DR
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City | KATY
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State | TX
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Zip | 77494-6819
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Country | US
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Telephone | 713-904-5222
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Fax |
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Provider Business Mailing Address
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Address Line | 5310 PEBBLE WAY LN
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City | HOUSTON
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State | TX
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Zip | 77041-6863
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 102901
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License Number State | TX
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