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General NPI Number Information
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NPI Number | 1245454768
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Entity Type | Organization
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Legal Business Name | INTERFACE-SAMARITAN COUNSELING CENTERS
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4803 SAN FELIPE ST
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City | HOUSTON
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State | TX
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Zip | 77056-3907
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Country | US
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Telephone | 713-626-7990
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Fax | 713-627-7715
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Provider Business Mailing Address
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Address Line | 4803 SAN FELIPE ST
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City | HOUSTON
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State | TX
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Zip | 77056-3907
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Country | US
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Telephone | 713-626-7990
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Fax | 713-627-7715
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Authorized Official
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Title or Position | PSYCHOLOGIST, CLINICAL DIRECTOR
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Name | DR. SUSAN ARNOLD LANGE
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Credential | PH.D.
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Telephone | 713-626-7990
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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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