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General NPI Number Information
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NPI Number | 1437406287
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Entity Type | Organization
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Legal Business Name | KINGWOOD PSYCHOTHERAPY & ASSESSMENT CENTER
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Dates
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Enumeration Date | 08/11/2012
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Last Update Date | 01/08/2013
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Provider Practice Location Address
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Address Line | 3910 W LAKE HOUSTON PKWY
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City | KINGWOOD
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State | TX
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Zip | 77339-5221
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Country | US
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Telephone | 832-291-6733
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Fax |
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Provider Business Mailing Address
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Address Line | 3910 W LAKE HOUSTON PKWY
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City | KINGWOOD
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State | TX
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Zip | 77339-5221
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Country | US
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Telephone | 832-291-6733
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. JONI A. ADAMS
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Credential | M.A., LPC
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Telephone | 832-291-6733
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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 | 61067
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License Number State | TX
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