MEDICARE: GREATER WITHIN ME COUNSELING, COACHING AND BEHAVIORAL CENTER, PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251B00000X	Case Management Agency
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
3	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1114628153
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREATER WITHIN ME COUNSELING, COACHING AND BEHAVIORAL CENTER, PLLC

Provider Business Mailing Address
First Line	:	11301 FALLBROOK DR STE 300
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77065-4272
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11301 FALLBROOK DR STE 300
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77065-4272
Country	:	US
Telephone Number	:	281-223-3393
Fax Number	:

Authorized Official
Title or Position	:	OWNER, CEO
Name	:	RHONDA HERNDON
Credential	:	LPC
Telephone Number	:	281-223-3393

Provider Enumeration Date	:	03/16/2023
Last Update Date	:	03/16/2023

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