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General NPI Number Information
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NPI Number | 1528084563
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Entity Type | Individual
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Provider Name | MOJIE A BURGOYNE LCSW, LPC, LMFT, ACC
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Gender | Female
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 701 W. MAIN SUITE 2
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City | TOMBALL
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State | TX
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Zip | 77375
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Country | US
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Telephone | 281-351-2461
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Fax | 281-351-9158
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Provider Business Mailing Address
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Address Line | PO BOX 167
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City | TOMBALL
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State | TX
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Zip | 77377
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Country | US
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Telephone | 281-351-2461
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Fax | 281-351-9158
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2176
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 00210
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 91
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License Number State | TX
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