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General NPI Number Information
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NPI Number | 1629639356
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Entity Type | Organization
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Legal Business Name | HEALING RIVERS COUNSELING
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Dates
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Enumeration Date | 06/24/2019
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Last Update Date | 06/24/2019
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Provider Practice Location Address
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Address Line | 9950 CYPRESSWOOD DR STE 224
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City | HOUSTON
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State | TX
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Zip | 77070-3413
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Country | US
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Telephone | 281-382-1474
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Fax | 281-547-8065
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Provider Business Mailing Address
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Address Line | 18106 GARNET RED RD
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City | CYPRESS
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State | TX
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Zip | 77429-1181
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Country | US
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Telephone | 281-382-1474
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Fax | 281-547-8065
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Authorized Official
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Title or Position | LPC
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Name | DR. SHARESE MARTIN
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Credential | PHD, LPC
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Telephone | 281-382-1474
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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 |
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License Number State |
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