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General NPI Number Information
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NPI Number | 1104523901
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Entity Type | Organization
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Legal Business Name | CHRIST THE KING PRESBYTERIAN CHURCH
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Dates
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Enumeration Date | 02/13/2023
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Last Update Date | 02/13/2023
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Provider Practice Location Address
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Address Line | 1201 SILBER RD
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City | HOUSTON
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State | TX
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Zip | 77055-7127
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Country | US
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Telephone | 713-892-5464
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Fax |
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Provider Business Mailing Address
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Address Line | 1201 SILBER RD
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City | HOUSTON
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State | TX
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Zip | 77055-7127
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Country | US
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Telephone | 713-892-5464
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF COUNSELING
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Name | LESLIE CARYL PEACOCK
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Credential | LPC
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Telephone | 713-892-5464
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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 |
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License Number State |
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