MEDICARE: SOCIAL HOUSE, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	72927	TX

General Provider Information

NPI Number	:	1013422245
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOCIAL HOUSE, PLLC

Provider Business Mailing Address
First Line	:	18031 GLENLEDI DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-5926
Country	:	US
Telephone Number	:	832-457-3081
Fax Number	:

Provider Business Practice Location Address
First Line	:	6714 N NEW BRAUNFELS AVE STE 105
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78209-3846
Country	:	US
Telephone Number	:	832-457-3081
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	MR. ADAM RAHMAN
Credential	:	M.A., LPC
Telephone Number	:	832-457-3081

Provider Enumeration Date	:	12/11/2017
Last Update Date	:	06/11/2019

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