Provider Demographics
NPI:1033486014
Name:TROSTLE, JON KIM (LPC)
Entity Type:Individual
Prefix:MR
First Name:JON
Middle Name:KIM
Last Name:TROSTLE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11999 KATY FREEWAY
Mailing Address - Street 2:STE. 490
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-1608
Mailing Address - Country:US
Mailing Address - Phone:281-597-9291
Mailing Address - Fax:281-597-9761
Practice Address - Street 1:11999 KATY FREEWAY
Practice Address - Street 2:STE. 490
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-1608
Practice Address - Country:US
Practice Address - Phone:281-597-9291
Practice Address - Fax:281-597-9761
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-19
Last Update Date:2011-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62348101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health