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NPI Code Detail

MEDICARE: INTERFACE-SAMARITAN COUNSELING CENTERS

MEDICARE: INTERFACE-SAMARITAN COUNSELING CENTERS
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1245454768
Entity Type Code : Organization
Provider Name (Legal Business Name) : INTERFACE-SAMARITAN COUNSELING CENTERS
Provider Business Mailing Address
First Line : 4803 SAN FELIPE ST
Second Line :
City : HOUSTON
State : TX
Zip : 77056-3907
Country : US
Telephone Number : 713-626-7990
Fax Number : 713-627-7715
Provider Business Practice Location Address
First Line : 4803 SAN FELIPE ST
Second Line :
City : HOUSTON
State : TX
Zip : 77056-3907
Country : US
Telephone Number : 713-626-7990
Fax Number : 713-627-7715
Authorized Official
Title or Position : PSYCHOLOGIST, CLINICAL DIRECTOR
Name : DR. SUSAN ARNOLD LANGE
Credential : PH.D.
Telephone Number : 713-626-7990
Provider Enumeration Date : 04/13/2007
Last Update Date : 08/22/2020

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Directions to “INTERFACE-SAMARITAN COUNSELING CENTERS ” Practice Location

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