MEDICARE: ADRIANA KALINCHUK, 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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1407479041
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADRIANA KALINCHUK, PLLC

Provider Business Mailing Address
First Line	:	7155 OLD KATY RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-2134
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7155 OLD KATY RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-2134
Country	:	US
Telephone Number	:	832-831-8379
Fax Number	:

Authorized Official
Title or Position	:	LICENSED PROFESSIONAL COUNSELOR
Name	:	ADRIANA KALINCHUK
Credential	:
Telephone Number	:	832-899-4248

Provider Enumeration Date	:	05/18/2020
Last Update Date	:	05/18/2021

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