MEDICARE: FAMILY CHRISTIAN COUNSELING CENTER INC.

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	14596	TX

General Provider Information

NPI Number	:	1134208622
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY CHRISTIAN COUNSELING CENTER INC.

Provider Business Mailing Address
First Line	:	9950 CYPRESSWOOD DR.
Second Line	:	SUITE 260
City	:	HOUSTON
State	:	TX
Zip	:	77070-3481
Country	:	US
Telephone Number	:	281-890-6234
Fax Number	:	281-890-6234

Provider Business Practice Location Address
First Line	:	9950 CYPRESSWOOD DR.
Second Line	:	SUITE 260
City	:	HOUSTON
State	:	TX
Zip	:	77070-3481
Country	:	US
Telephone Number	:	281-890-6234
Fax Number	:	281-890-6234

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. GARY R. LYNN
Credential	:	M.ED., LPC, NCC
Telephone Number	:	281-890-6234

Provider Enumeration Date	:	11/03/2006
Last Update Date	:	08/22/2020

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