MEDICARE: NATIONAL 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	101YP2500X	Professional Counselor	65570	TX

General Provider Information

NPI Number	:	1144519893
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATIONAL COUNSELING CENTER

Provider Business Mailing Address
First Line	:	18123 TIMBER CROSSING LN
Second Line	:
City	:	CYPRESS
State	:	TX
Zip	:	77433-1520
Country	:	US
Telephone Number	:	713-502-2974
Fax Number	:

Provider Business Practice Location Address
First Line	:	10001 WESTHEIMER RD
Second Line	:	SUITE 2115
City	:	HOUSTON
State	:	TX
Zip	:	77042-3151
Country	:	US
Telephone Number	:	713-581-1008
Fax Number	:	713-782-0515

Authorized Official
Title or Position	:	OWNER
Name	:	MR. EMILIO JIMENEZ
Credential	:	MA. LPC
Telephone Number	:	713-502-2974

Provider Enumeration Date	:	04/04/2011
Last Update Date	:	04/04/2011

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Directions to “NATIONAL COUNSELING CENTER ” Practice Location

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