Provider Demographics
NPI:1427479419
Name:PAULSON, COREY (MA NCC LPC)
Entity type:Individual
Prefix:
First Name:COREY
Middle Name:
Last Name:PAULSON
Suffix:
Gender:M
Credentials:MA NCC LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 STONECREST DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018-7524
Mailing Address - Country:US
Mailing Address - Phone:281-624-6904
Mailing Address - Fax:
Practice Address - Street 1:1010 STONECREST DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018-7524
Practice Address - Country:US
Practice Address - Phone:281-624-6904
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-18
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67749101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional