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General NPI Number Information
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NPI Number | 1447736061
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Entity Type | Organization
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Legal Business Name | JUDAH CHRISTIAN COUNSELING & RECOVERY PLLC
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Dates
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Enumeration Date | 07/17/2018
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Last Update Date | 07/17/2018
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Provider Practice Location Address
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Address Line | 3017 YOST BLVD
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City | PEARLAND
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State | TX
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Zip | 77581-5543
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Country | US
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Telephone | 281-813-7360
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 841665
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City | PEARLAND
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State | TX
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Zip | 77584-0020
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Country | US
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Telephone | 281-813-7360
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHARLES HUSTON MCCOMB JR.
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Credential | LPC-S
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Telephone | 281-813-7360
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | 62699
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License Number State | TX
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