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General NPI Number Information
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NPI Number | 1891450656
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Entity Type | Organization
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Legal Business Name | MACK COUNSELING PLLC
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Dates
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Enumeration Date | 11/05/2021
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Last Update Date | 01/12/2024
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Provider Practice Location Address
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Address Line | 7322 SOUTHWEST FWY STE 1055
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City | HOUSTON
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State | TX
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Zip | 77074-2089
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Country | US
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Telephone | 346-279-8175
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Fax |
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Provider Business Mailing Address
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Address Line | 7322 SOUTHWEST FWY STE 1055
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City | HOUSTON
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State | TX
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Zip | 77074-2089
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Country | US
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Telephone | 346-279-8175
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | KEARA MACK
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Credential |
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Telephone | 281-903-0124
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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