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General NPI Number Information
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NPI Number | 1912330994
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Entity Type | Organization
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Legal Business Name | PIERCE COUNSELING
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Dates
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Enumeration Date | 08/14/2013
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Last Update Date | 01/30/2014
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Provider Practice Location Address
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Address Line | 909 MYRTLE CREEK DR
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City | LA PORTE
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State | TX
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Zip | 77571-2767
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Country | US
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Telephone | 832-794-3209
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Fax | 832-534-3273
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Provider Business Mailing Address
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Address Line | 909 MYRTLE CREEK DR
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City | LA PORTE
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State | TX
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Zip | 77571-2767
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Country | US
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Telephone | 832-794-3209
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Fax | 832-534-3273
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | JEREMY PIERCE
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Credential | MA, LPC, LMFT
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Telephone | 832-794-3209
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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 | 201572
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License Number State | TX
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