MEDICARE: IKP COUNSELING CENTER

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1083867139
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IKP COUNSELING CENTER

Provider Business Mailing Address
First Line	:	363 N SAM HOUSTON PKWY E
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77060-2404
Country	:	US
Telephone Number	:	281-820-7880
Fax Number	:	281-820-7881

Provider Business Practice Location Address
First Line	:	363 N SAM HOUSTON PKWY E
Second Line	:	SUITE 1100
City	:	HOUSTON
State	:	TX
Zip	:	77060-2404
Country	:	US
Telephone Number	:	713-377-8632
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST
Name	:	MS. INGA KENYATTA PINSON
Credential	:	LPC, LMFT
Telephone Number	:	713-377-8632

Provider Enumeration Date	:	11/01/2008
Last Update Date	:	11/01/2008

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