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NPI Code Detail

MEDICARE: AUDRA A BLYTHE LPC

MEDICARE: AUDRA A BLYTHE LPC
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
1101YP2500XProfessional Counselor99310TX

General Provider Information

NPI Number : 1114393204
Entity Type Code : Individual
Provider Name (Legal Business Name) : AUDRA A BLYTHE LPC
Provider Business Mailing Address
First Line : 4635 SOUTHWEST FWY STE 635
Second Line :
City : HOUSTON
State : TX
Zip : 77027-7112
Country : US
Telephone Number : 713-850-0049
Fax Number : 713-627-7302
Provider Business Practice Location Address
First Line : 4635 SOUTHWEST FWY STE 635
Second Line :
City : HOUSTON
State : TX
Zip : 77027-7112
Country : US
Telephone Number : 713-850-0049
Fax Number : 713-627-7302
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2015
Last Update Date : 02/11/2026

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Directions to “ AUDRA A BLYTHE LPC” Practice Location

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