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General NPI Number Information
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NPI Number | 1821167842
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Entity Type | Individual
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Provider Name | ELIZABETH BETTY DIVINE LPC, LCDC
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Gender | Female
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 4803 SAN FELIPE ST
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City | HOUSTON
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State | TX
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Zip | 77056-3907
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Country | US
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Telephone | 713-626-7990
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Fax | 713-627-7715
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Provider Business Mailing Address
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Address Line | 5855 DOLIVER DR
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City | HOUSTON
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State | TX
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Zip | 77057-2474
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Country | US
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Telephone | 713-857-7755
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Fax | 713-627-7715
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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 | LCDC8902
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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 | LPC17841
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License Number State | TX
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