Provider Demographics
NPI:1811362890
Name:AMERSON, SANDRA J (MA, LPC-S, LCDC)
Entity type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:J
Last Name:AMERSON
Suffix:
Gender:F
Credentials:MA, LPC-S, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 N POST OAK RD STE 150
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-5413
Mailing Address - Country:US
Mailing Address - Phone:713-589-4730
Mailing Address - Fax:
Practice Address - Street 1:5715 OAKHAM ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77085-3300
Practice Address - Country:US
Practice Address - Phone:713-417-6701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-02
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4969101YA0400X
TX64868101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)