Provider Demographics
NPI:1104077957
Name:POCASANGRE, SUSAN LYNNE (LPC, LSOTP)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:LYNNE
Last Name:POCASANGRE
Suffix:
Gender:F
Credentials:LPC, LSOTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2910 COMMERCIAL CENTER BLVD
Mailing Address - Street 2:SUITE 103-206
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-6583
Mailing Address - Country:US
Mailing Address - Phone:281-705-8049
Mailing Address - Fax:713-776-9759
Practice Address - Street 1:9100 SOUTHWEST FWY
Practice Address - Street 2:SUITE 152
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1519
Practice Address - Country:US
Practice Address - Phone:281-705-8049
Practice Address - Fax:713-776-9759
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-09
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99063101Y00000X
TX17855101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor