MEDICARE: DIVINE COUNSELING SERVICE, LLC

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	261QA0600X	Adult Day Care Clinic/Center
2	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1871380899
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIVINE COUNSELING SERVICE, LLC

Provider Business Mailing Address
First Line	:	6201 BONHOMME RD STE 174N
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77036-4367
Country	:	US
Telephone Number	:	832-864-3347
Fax Number	:	833-466-1681

Provider Business Practice Location Address
First Line	:	6201 BONHOMME RD STE 174N
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77036-4367
Country	:	US
Telephone Number	:	832-864-3347
Fax Number	:	833-466-1681

Authorized Official
Title or Position	:	OWNER
Name	:	CRYSTAL ALEXIA JEFFREY
Credential	:	LCDC
Telephone Number	:	832-864-3347

Provider Enumeration Date	:	04/23/2025
Last Update Date	:	03/30/2026

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Directions to “DIVINE COUNSELING SERVICE, LLC ” Practice Location

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