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General NPI Number Information
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NPI Number | 1194099424
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Entity Type | Organization
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Legal Business Name | COMPREHNESIVE ASSESSMENT AND COUNSLEING CONNECTIONS
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Dates
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Enumeration Date | 03/05/2012
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Last Update Date | 03/05/2012
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Provider Practice Location Address
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Address Line | 100 I 45 N STE 125A
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City | CONROE
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State | TX
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Zip | 77301-2890
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Country | US
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Telephone | 936-441-3556
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Fax | 936-756-3555
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Provider Business Mailing Address
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Address Line | 100 I 45 N STE 125A
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City | CONROE
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State | TX
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Zip | 77301-2890
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Country | US
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Telephone | 936-441-3556
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Fax | 936-756-3555
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | KASSANDRA HUMPHRESS
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Credential | LPC
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Telephone | 936-441-3556
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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 | 65603
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License Number State | TX
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