MEDICARE: TILTING AT WINDMILLS 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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1902402142
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TILTING AT WINDMILLS PLLC

Provider Business Mailing Address
First Line	:	1010 STONECREST DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77018-7524
Country	:	US
Telephone Number	:	281-624-6904
Fax Number	:

Provider Business Practice Location Address
First Line	:	1010 STONECREST DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77018-7524
Country	:	US
Telephone Number	:	281-624-6904
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	COREY DEAN PAULSON
Credential	:	LPC
Telephone Number	:	281-624-6904

Provider Enumeration Date	:	12/10/2020
Last Update Date	:	08/16/2021

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