Provider Demographics
NPI:1225872120
Name:JARRETT, ALICIA BERGERON (MA, LPC, NCC)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:BERGERON
Last Name:JARRETT
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:FAYE
Other - Last Name:BERGERON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11300 WEST ROAD
Mailing Address - Street 2:STE J PMB #33
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065
Mailing Address - Country:US
Mailing Address - Phone:281-865-3120
Mailing Address - Fax:
Practice Address - Street 1:10203 CROOKS WAY CT
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-4167
Practice Address - Country:US
Practice Address - Phone:281-865-3120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX903777101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health