Provider Demographics
NPI:1528525052
Name:DISHMON COUNSELING & ASSOCIATES
Entity type:Organization
Organization Name:DISHMON COUNSELING & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MADONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:DISHMON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:281-513-1189
Mailing Address - Street 1:12250 S KIRKWOOD RD APT 1235
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-2124
Mailing Address - Country:US
Mailing Address - Phone:281-513-1189
Mailing Address - Fax:
Practice Address - Street 1:519 N SAM HOUSTON PKWY E STE 450-R
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-4125
Practice Address - Country:US
Practice Address - Phone:281-513-1189
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-20
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty