Provider Demographics
NPI:1891515813
Name:DUCROS, MI'CAH TALOR (LMFT)
Entity type:Individual
Prefix:
First Name:MI'CAH
Middle Name:TALOR
Last Name:DUCROS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1406 ANVIL DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-2112
Mailing Address - Country:US
Mailing Address - Phone:713-444-0228
Mailing Address - Fax:
Practice Address - Street 1:17844 MOUND RD STE H
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-4919
Practice Address - Country:US
Practice Address - Phone:281-944-7922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX204627106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist