Provider Demographics
NPI:1043820285
Name:HOUSTON, KEVIN (LPC)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:
Last Name:HOUSTON
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 1:10074 BLACK MAPLE DR
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77385-1502
Mailing Address - Country:US
Mailing Address - Phone:832-623-0354
Mailing Address - Fax:
Practice Address - Street 1:19701 KINGWOOD DR # 300
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-3773
Practice Address - Country:US
Practice Address - Phone:281-358-5701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-03
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80509101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty