MEDICARE: GINMAN CONSULTING AND COUNSELING ASSOCIATES, PC

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	68015	OTHER	TX	LPC #

General Provider Information

NPI Number	:	1639799976
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GINMAN CONSULTING AND COUNSELING ASSOCIATES, PC

Provider Business Mailing Address
First Line	:	2626 S LOOP W STE 650H
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-5628
Country	:	US
Telephone Number	:	281-904-6483
Fax Number	:	866-319-9168

Provider Business Practice Location Address
First Line	:	2626 S LOOP W STE 650H
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-5628
Country	:	US
Telephone Number	:	281-904-6483
Fax Number	:	866-319-9168

Authorized Official
Title or Position	:	CEO
Name	:	VIRGINIA ELAM MANNING
Credential	:	LPC-S, LCDC, ADC
Telephone Number	:	281-904-6483

Provider Enumeration Date	:	04/16/2020
Last Update Date	:	04/16/2020

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