=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154725786
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEART TO HEART COUNSELING SERVICE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/10/2014
-----------------------------------------------------
Last Update Date | 05/28/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4855 RIVERSTONE BLVD STE 102
-----------------------------------------------------
City | MISSOURI CITY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77459-4378
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-945-3139
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4855 RIVERSTONE BLVD STE 102
-----------------------------------------------------
City | MISSOURI CITY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77459-4378
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-656-8058
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/THERAPIST
-----------------------------------------------------
Name | MRS. ALAINA MARIE SANDERSON-LOPEZ
-----------------------------------------------------
Credential | MS, LPC
-----------------------------------------------------
Telephone | 832-656-8058
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------