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General NPI Number Information
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NPI Number | 1679062269
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Entity Type | Organization
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Legal Business Name | HUMAN STATE OF MIND COUNSELING, PLLC
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Dates
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Enumeration Date | 05/09/2018
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Last Update Date | 01/26/2021
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Provider Practice Location Address
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Address Line | 535 W 20TH ST STE 205
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City | HOUSTON
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State | TX
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Zip | 77008-3660
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Country | US
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Telephone | 210-288-3699
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Fax |
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Provider Business Mailing Address
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Address Line | 907 NICHOLSON ST
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City | HOUSTON
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State | TX
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Zip | 77008-6749
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Country | US
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Telephone | 210-288-3699
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | STEPHANIE LONGTAIN
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Credential | LCSW
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Telephone | 210-288-3699
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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