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General NPI Number Information
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NPI Number | 1174857189
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Entity Type | Organization
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Legal Business Name | INNOVATIONS COUNSELING AND CONSULTING PLLC
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Dates
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Enumeration Date | 09/23/2009
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Last Update Date | 09/23/2009
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Provider Practice Location Address
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Address Line | 11999 KATY FWY SUITE 490
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City | HOUSTON
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State | TX
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Zip | 77079-1611
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Country | US
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Telephone | 281-597-9291
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Fax | 281-597-9761
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Provider Business Mailing Address
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Address Line | 11999 KATY FWY SUITE 490
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City | HOUSTON
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State | TX
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Zip | 77079-1611
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Country | US
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Telephone | 281-597-9291
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Fax | 281-597-9761
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Authorized Official
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Title or Position | MANAGING OWNER
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Name | MR. KEVIN PAYNE GLASSER
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Credential | MA, LPC
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Telephone | 281-597-9291
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 12634
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License Number State | TX
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