MEDICARE: AESHA DESAI LPC-A, NCC, CCTP

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	100106	TX

General Provider Information

NPI Number	:	1801768916
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AESHA DESAI LPC-A, NCC, CCTP

Provider Business Mailing Address
First Line	:	4632 GILA BEND LN
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76137-6174
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2010 NORTH LOOP W STE 240
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77018-8125
Country	:	US
Telephone Number	:	281-626-0505
Fax Number	:

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

Provider Enumeration Date	:	09/18/2025
Last Update Date	:	09/18/2025

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