Provider Demographics
NPI:1316495344
Name:MEMORIAL COMPREHENSIVE COUNSELING, LLC
Entity type:Organization
Organization Name:MEMORIAL COMPREHENSIVE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MONIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LPC
Authorized Official - Phone:713-443-6878
Mailing Address - Street 1:13806 BRITOAK LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-3325
Mailing Address - Country:US
Mailing Address - Phone:713-443-6878
Mailing Address - Fax:
Practice Address - Street 1:14133 MEMORIAL DR
Practice Address - Street 2:SUITE 4
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-6857
Practice Address - Country:US
Practice Address - Phone:713-443-6878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-20
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72710101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty