Provider Demographics
NPI:1003928706
Name:PENA, LUIS J (MA, LPC)
Entity Type:Individual
Prefix:MR
First Name:LUIS
Middle Name:J
Last Name:PENA
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5311 KIRBY DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-1364
Mailing Address - Country:US
Mailing Address - Phone:713-529-6555
Mailing Address - Fax:713-529-6553
Practice Address - Street 1:5311 KIRBY DR
Practice Address - Street 2:SUITE 110
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77005-1364
Practice Address - Country:US
Practice Address - Phone:713-529-6555
Practice Address - Fax:713-529-6553
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12243101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health