MEDICARE: MS. ABIMBOLA OLUWABUNMI FARINDE PHD, 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	101YM0800X	Mental Health Counselor	74547	TX
2	183500000X	Pharmacist	45724	TX

General Provider Information

NPI Number	:	1639367873
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ABIMBOLA OLUWABUNMI FARINDE PHD, LPC, LCDC

Provider Business Mailing Address
First Line	:	11703 BEECHNUT STREET #720959
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77072-9998
Country	:	US
Telephone Number	:	832-980-5797
Fax Number	:	832-890-5797

Provider Business Practice Location Address
First Line	:	11703 BEECHNUT STREET #720959
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77072-9998
Country	:	US
Telephone Number	:	832-980-5797
Fax Number	:	832-890-5797

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

Provider Enumeration Date	:	10/12/2007
Last Update Date	:	07/20/2020

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