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General NPI Number Information
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NPI Number | 1821650573
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Entity Type | Organization
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Legal Business Name | MONTGOMERY COUNTY COUNSELING WORKS, PLLC
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Dates
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Enumeration Date | 07/02/2019
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Last Update Date | 07/02/2019
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Provider Practice Location Address
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Address Line | 25511 BUDDE RD STE 3601
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City | THE WOODLANDS
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State | TX
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Zip | 77380-2080
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Country | US
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Telephone | 979-235-0447
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Fax |
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Provider Business Mailing Address
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Address Line | 124 MALLARD CREEK CT
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City | MONTGOMERY
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State | TX
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Zip | 77316-1868
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Country | US
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Telephone | 979-235-0447
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Fax |
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Authorized Official
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Title or Position | CLINICAL THERAPIST AND OWNER
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Name | MRS. KAREN RENEE GRESHAM
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Credential | LPC, NCC
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Telephone | 979-235-0447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 |
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