MEDICARE: MC HEALTH INITIATIVE PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251S00000X	Community/Behavioral Health Agency
2	101YM0800X	Mental Health Counselor
3	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
4	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1225845589
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MC HEALTH INITIATIVE PLLC

Provider Business Mailing Address
First Line	:	3634 GLENN LAKES LN STE 266
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-4185
Country	:	US
Telephone Number	:	281-948-5176
Fax Number	:

Provider Business Practice Location Address
First Line	:	3634 GLENN LAKES LN STE 266
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-4185
Country	:	US
Telephone Number	:	281-948-5176
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ASIA MCCLENON
Credential	:	LPC
Telephone Number	:	832-862-7997

Provider Enumeration Date	:	12/11/2024
Last Update Date	:	12/11/2024

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