MEDICARE: HYACINTH 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	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1912726720
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HYACINTH COUNSELING PLLC

Provider Business Mailing Address
First Line	:	5515 QUEENSLOCH DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77096-4029
Country	:	US
Telephone Number	:	281-733-5955
Fax Number	:

Provider Business Practice Location Address
First Line	:	5515 QUEENSLOCH DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77096-4029
Country	:	US
Telephone Number	:	281-733-5955
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MAGGIE BURKETT
Credential	:
Telephone Number	:	281-733-5955

Provider Enumeration Date	:	10/08/2024
Last Update Date	:	10/08/2024

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