MEDICARE: ABIGAIL ELLEN REINER LPC,LCDC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	16662	TX
2	101YP2500X	Professional Counselor	95032	TX

General Provider Information

NPI Number	:	1306689658
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABIGAIL ELLEN REINER LPC,LCDC

Provider Business Mailing Address
First Line	:	839 BLACKSHIRE LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77055-1929
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3410 MERCER ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77027-6508
Country	:	US
Telephone Number	:	832-524-0770
Fax Number	:

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

Provider Enumeration Date	:	06/14/2024
Last Update Date	:	06/14/2024

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