MEDICARE: EL CAMINO COUNSELING, PLLC

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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841595949
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EL CAMINO COUNSELING, PLLC

Provider Business Mailing Address
First Line	:	10245 KEMPWOOD DR STE E
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77043-1840
Country	:	US
Telephone Number	:	713-647-0002
Fax Number	:	713-647-0885

Provider Business Practice Location Address
First Line	:	10245 KEMPWOOD DR # 218
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77043-1803
Country	:	US
Telephone Number	:	713-647-0002
Fax Number	:	713-647-0885

Authorized Official
Title or Position	:	OWNER
Name	:	JURI LEE
Credential	:	LPC-S
Telephone Number	:	713-647-0002

Provider Enumeration Date	:	01/20/2011
Last Update Date	:	12/16/2024

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