MEDICARE: MOVING FORWARD

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	68363

General Provider Information

NPI Number	:	1629404553
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOVING FORWARD

Provider Business Mailing Address
First Line	:	7802 LIVINGSTON ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77051-1532
Country	:	US
Telephone Number	:	713-734-8800
Fax Number	:	713-734-8775

Provider Business Practice Location Address
First Line	:	7802 LIVINGSTON ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77051-1532
Country	:	US
Telephone Number	:	713-734-8800
Fax Number	:	713-734-8775

Authorized Official
Title or Position	:	OWNER
Name	:	SADA OKOLO
Credential	:	M.A., LPC
Telephone Number	:	713-256-7858

Provider Enumeration Date	:	09/24/2013
Last Update Date	:	09/24/2013

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Directions to “MOVING FORWARD ” Practice Location

Language	Start Address	Practice Location

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