MEDICARE: LETS TALK ILL LISTEN COUNSELING SERVICES

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1760010631
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LETS TALK ILL LISTEN COUNSELING SERVICES

Provider Business Mailing Address
First Line	:	7676 HILLMONT ST STE 204
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77040-6469
Country	:	US
Telephone Number	:	978-400-3016
Fax Number	:

Provider Business Practice Location Address
First Line	:	7676 HILLMONT ST STE 204
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77040-6469
Country	:	US
Telephone Number	:	978-400-3016
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER/CEO
Name	:	SHANNON N MARTIN
Credential	:	LPC
Telephone Number	:	978-400-3016

Provider Enumeration Date	:	03/27/2020
Last Update Date	:	06/18/2024

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