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General NPI Number Information
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NPI Number | 1871464602
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Entity Type | Individual
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Provider Name | LUCIANA WALLENSTEIN
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Gender | Female
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Dates
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Enumeration Date | 09/15/2025
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Last Update Date | 09/15/2025
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Provider Practice Location Address
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Address Line | 120 ELDRIDGE RD STE D
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City | SUGAR LAND
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State | TX
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Zip | 77478-4640
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Country | US
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Telephone | 936-463-8313
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Fax |
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Provider Business Mailing Address
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Address Line | 13543 N TRACEWOOD BND
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City | HOUSTON
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State | TX
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Zip | 77077-1536
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Country | US
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Telephone | 713-628-2292
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 203245
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 80375
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License Number State | TX
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