MEDICARE: DENISE SERVIN LPC-I

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	81154	TX

General Provider Information

NPI Number	:	1205391661
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENISE SERVIN LPC-I

Provider Business Mailing Address
First Line	:	18011 AUTUMN HILLS DR
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77449-4419
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3880 GREENHOUSE RD STE 411
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-3486
Country	:	US
Telephone Number	:	713-503-7606
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2019
Last Update Date	:	02/08/2019

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Directions to “ DENISE SERVIN LPC-I” Practice Location

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