Provider Demographics
NPI:1023357043
Name:PENA, TAMARA DENISE (LCDC, LPC-S, NCC)
Entity Type:Individual
Prefix:MS
First Name:TAMARA
Middle Name:DENISE
Last Name:PENA
Suffix:
Gender:F
Credentials:LCDC, LPC-S, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2626 S LOOP W STE 225
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2693
Mailing Address - Country:US
Mailing Address - Phone:832-203-5987
Mailing Address - Fax:832-203-4086
Practice Address - Street 1:2626 S LOOP W STE 225
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2693
Practice Address - Country:US
Practice Address - Phone:832-203-5987
Practice Address - Fax:832-203-4086
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-12
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67578101Y00000X, 101YM0800X, 251S00000X, 101YP2500X
101Y00000X, 225C00000X, 251S00000X
TX14131101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1023357043OtherNPI DATABASE
TX1144720889OtherNPI DATABASE