MEDICARE: MIND AND FAITH COUNSELING GROUP LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101Y00000X	Counselor
2	101YP2500X	Professional Counselor
3	101YP1600X	Pastoral Counselor
4	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1073477196
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIND AND FAITH COUNSELING GROUP LLC

Provider Business Mailing Address
First Line	:	1550 FOXLAKE DR APT 10312
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-4759
Country	:	US
Telephone Number	:	346-677-4604
Fax Number	:

Provider Business Practice Location Address
First Line	:	1550 FOXLAKE DR APT 10312
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-4759
Country	:	US
Telephone Number	:	346-677-4604
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	KIZZY ALTAMEEMI
Credential	:
Telephone Number	:	346-677-4604

Provider Enumeration Date	:	12/12/2025
Last Update Date	:	12/12/2025

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Directions to “MIND AND FAITH COUNSELING GROUP LLC ” Practice Location

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