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General NPI Number Information
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NPI Number | 1689497109
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Entity Type | Individual
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Provider Name | KENYATTA SADIKI LCDC, CART
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Gender | Male
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Dates
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Enumeration Date | 11/04/2024
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 7322 SOUTHWEST FWY STE 1136
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City | HOUSTON
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State | TX
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Zip | 77074-2066
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Country | US
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Telephone | 713-679-0219
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Fax |
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Provider Business Mailing Address
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Address Line | 7322 SOUTHWEST FWY STE 1136
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City | HOUSTON
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State | TX
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Zip | 77074-2066
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Country | US
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Telephone | 713-679-0219
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Fax |
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 14393
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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