Provider Demographics
NPI:1083486195
Name:MASTERSON, NANETTE LAURA (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:NANETTE
Middle Name:LAURA
Last Name:MASTERSON
Suffix:
Gender:F
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 1:25507 LOCKSPUR DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-4340
Mailing Address - Country:US
Mailing Address - Phone:281-344-7660
Mailing Address - Fax:
Practice Address - Street 1:402 JULIE RIVERS DR
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3144
Practice Address - Country:US
Practice Address - Phone:281-277-8811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-23
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX84644101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty