Provider Demographics
NPI:1033503586
Name:HOUSE, DOUGLAS LOWELL JR (LPC)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:LOWELL
Last Name:HOUSE
Suffix:JR
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 1:11414 UNBRIDLED
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78245-3818
Mailing Address - Country:US
Mailing Address - Phone:915-820-0754
Mailing Address - Fax:
Practice Address - Street 1:11414 UNBRIDLED
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78245-3818
Practice Address - Country:US
Practice Address - Phone:915-820-0754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-23
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX77760101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health