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General NPI Number Information
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NPI Number | 1588185169
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Entity Type | Organization
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Legal Business Name | AHAVA COUNSELING & MEDIATION PRACTICE, LLC
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Dates
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Enumeration Date | 07/04/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 8300 FM 1960 RD W
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City | HOUSTON
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State | TX
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Zip | 77070-5654
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Country | US
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Telephone | 832-715-8306
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 331675
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City | HOUSTON
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State | TX
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Zip | 77233-1675
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Country | US
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Telephone | 832-715-8306
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | BRITTANY COOK
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Credential | LPC
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Telephone | 832-715-8306
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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 | 74801
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 74801
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 74801
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License Number State | TX
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