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General NPI Number Information
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NPI Number | 1225845589
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Entity Type | Organization
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Legal Business Name | MC HEALTH INITIATIVE PLLC
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Dates
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Enumeration Date | 12/11/2024
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 3634 GLENN LAKES LN STE 266
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City | MISSOURI CITY
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State | TX
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Zip | 77459-4185
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Country | US
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Telephone | 281-948-5176
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Fax |
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Provider Business Mailing Address
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Address Line | 3634 GLENN LAKES LN STE 266
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City | MISSOURI CITY
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State | TX
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Zip | 77459-4185
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Country | US
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Telephone | 281-948-5176
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ASIA MCCLENON
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Credential | LPC
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Telephone | 832-862-7997
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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