MEDICARE: HOUSTON AREA URBAN CONNECT PLLC

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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1386317451
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOUSTON AREA URBAN CONNECT PLLC

Provider Business Mailing Address
First Line	:	2925 RICHMOND AVE STE 1200
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-3143
Country	:	US
Telephone Number	:	832-564-9299
Fax Number	:

Provider Business Practice Location Address
First Line	:	2925 RICHMOND AVE STE 1200
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-3143
Country	:	US
Telephone Number	:	832-564-9299
Fax Number	:

Authorized Official
Title or Position	:	LICENSED PROFESSIONAL COUNSELOR
Name	:	ARICA NOEL BIBBS
Credential	:	LPC
Telephone Number	:	832-564-9299

Provider Enumeration Date	:	07/26/2021
Last Update Date	:	07/27/2021

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