Provider Demographics
NPI:1225859242
Name:PROVIDENCE COUNSELING AND CONSULTING PLLC
Entity type:Organization
Organization Name:PROVIDENCE COUNSELING AND CONSULTING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:PRIYE
Authorized Official - Middle Name:
Authorized Official - Last Name:MUKORO
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:713-487-9595
Mailing Address - Street 1:2818 FIR CREST CT
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-6006
Mailing Address - Country:US
Mailing Address - Phone:713-487-9595
Mailing Address - Fax:281-261-8772
Practice Address - Street 1:2818 FIR CREST CT
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-6006
Practice Address - Country:US
Practice Address - Phone:713-487-9595
Practice Address - Fax:281-261-8772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-22
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health