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General NPI Number Information
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NPI Number | 1740652114
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Entity Type | Individual
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Provider Name | THERESA COULEHAN MA, LPC
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Gender | Female
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Dates
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Enumeration Date | 10/26/2015
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Last Update Date | 10/29/2015
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Provider Practice Location Address
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Address Line | 1415 NORTH LOOP W STE. 1010
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City | HOUSTON
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State | TX
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Zip | 77008-1664
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Country | US
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Telephone | 281-948-5110
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Fax |
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Provider Business Mailing Address
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Address Line | 13310 BRIDGEWALK LN
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City | HOUSTON
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State | TX
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Zip | 77041-5888
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Country | US
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Telephone | 281-948-5110
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 70168
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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 | 70168
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License Number State | TX
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