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General NPI Number Information
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NPI Number | 1639528789
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Entity Type | Organization
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Legal Business Name | PETTIS COUNSELING, PLLC
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Dates
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Enumeration Date | 06/09/2016
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Last Update Date | 06/09/2016
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Provider Practice Location Address
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Address Line | 505 N SAM HOUSTON PKWY E SUITE 154
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City | HOUSTON
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State | TX
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Zip | 77060-4018
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Country | US
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Telephone | 281-222-6714
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Fax | 832-777-6031
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Provider Business Mailing Address
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Address Line | 505 N SAM HOUSTON PKWY E SUITE 154
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City | HOUSTON
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State | TX
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Zip | 77060-4018
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Country | US
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Telephone | 281-222-6714
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Fax | 832-777-6031
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Authorized Official
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Title or Position | MANAGER
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Name | DR. LINDA PETTIS ELLIS
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Credential |
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Telephone | 281-222-6714
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number |
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number |
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State | TX
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