Provider Demographics
NPI:1093573594
Name:URBAN, AYSHA (LPC-A, LCDC)
Entity Type:Individual
Prefix:
First Name:AYSHA
Middle Name:
Last Name:URBAN
Suffix:
Gender:F
Credentials:LPC-A, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 BONNIE BRAE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-5217
Mailing Address - Country:US
Mailing Address - Phone:832-454-9764
Mailing Address - Fax:
Practice Address - Street 1:900 LOVETT BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-3908
Practice Address - Country:US
Practice Address - Phone:713-429-0315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-08
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX88956101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health