MEDICARE: BEAUTY FOR ASHES COUNSELING SERVICE

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	101YP1600X	Pastoral Counselor	100-10488	TX

General Provider Information

NPI Number	:	1255541140
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEAUTY FOR ASHES COUNSELING SERVICE

Provider Business Mailing Address
First Line	:	7535 ASHBURN ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77061-1503
Country	:	US
Telephone Number	:	713-649-7925
Fax Number	:

Provider Business Practice Location Address
First Line	:	7535 ASHBURN ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77061-1503
Country	:	US
Telephone Number	:	713-649-7925
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER AND PRESIDENT
Name	:	MRS. DORIS JEAN PAYTON
Credential	:	LCDC, CCC
Telephone Number	:	713-649-7925

Provider Enumeration Date	:	05/22/2007
Last Update Date	:	08/22/2020

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