Provider Demographics
NPI:1699541318
Name:OSUNMO, CARLENE A (LPC LCDC)
Entity type:Individual
Prefix:MS
First Name:CARLENE
Middle Name:A
Last Name:OSUNMO
Suffix:
Gender:F
Credentials:LPC LCDC
Other - Prefix:MS
Other - First Name:CARLENE
Other - Middle Name:A
Other - Last Name:OSUNMO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPCLCDC
Mailing Address - Street 1:15419 WELDON DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77032-2082
Mailing Address - Country:US
Mailing Address - Phone:832-885-7115
Mailing Address - Fax:
Practice Address - Street 1:15419 WELDON DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77032-2082
Practice Address - Country:US
Practice Address - Phone:832-885-7115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14295101YA0400X
86282101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)