Provider Demographics
NPI:1194084277
Name:HOUSTON, THOMAS CHARLES (DMIN)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:CHARLES
Last Name:HOUSTON
Suffix:
Gender:M
Credentials:DMIN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3776 S CHASE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80235-2954
Mailing Address - Country:US
Mailing Address - Phone:720-254-0951
Mailing Address - Fax:
Practice Address - Street 1:1777 S HARRISON ST
Practice Address - Street 2:SUITE 1200
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-3925
Practice Address - Country:US
Practice Address - Phone:720-254-0951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-10
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0718101YP1600X
CO0558101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO0718OtherAMERICAN ASSOCIATION OF CHRISTIAN COUNSELORS
CO0558OtherAMERICAN ASSOCIATION OF CHRISTIAN COUNSELORS