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General NPI Number Information
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NPI Number | 1386209401
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Entity Type | Individual
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Provider Name | RUBEN QUINTANA MSW LCDC
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Gender | Male
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Dates
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Enumeration Date | 05/03/2019
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Last Update Date | 01/04/2023
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Provider Practice Location Address
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Address Line | 6315 GULFTON ST
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City | HOUSTON
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State | TX
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Zip | 77081-1107
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Country | US
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Telephone | 713-457-4372
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Fax |
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Provider Business Mailing Address
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Address Line | 6315 GULFTON ST
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City | HOUSTON
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State | TX
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Zip | 77081-1107
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Country | US
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Telephone | 713-457-4372
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | BBH-LAC-LIC-38931
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | BBHSWLCLIC44815
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License Number State | MT
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 16226
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License Number State | TX
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