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General NPI Number Information
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NPI Number | 1841586377
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Entity Type | Organization
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Legal Business Name | COUNSELING CENTER OF MONTGOMERY COUNTY
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Dates
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Enumeration Date | 06/23/2011
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Last Update Date | 06/23/2011
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Provider Practice Location Address
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Address Line | 212 CONROE DR
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City | CONROE
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State | TX
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Zip | 77301-1950
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Country | US
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Telephone | 936-444-3546
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Fax |
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Provider Business Mailing Address
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Address Line | 212 CONROE DR
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City | CONROE
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State | TX
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Zip | 77301-1950
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Country | US
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Telephone | 936-444-3546
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR - S
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Name | REBECCA SMITH
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Credential | LPC-S
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Telephone | 936-444-3546
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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 | 61098
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License Number State | TX
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