Provider Demographics
NPI:1104042878
Name:HOUSTON, DENISE L (MA, LPC)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:L
Last Name:HOUSTON
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 1:101 BARRINGTON PL
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-4921
Mailing Address - Country:US
Mailing Address - Phone:678-431-1339
Mailing Address - Fax:786-585-9261
Practice Address - Street 1:327 DAHLONEGA ST
Practice Address - Street 2:SUITE 1801A
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-2480
Practice Address - Country:US
Practice Address - Phone:678-431-1339
Practice Address - Fax:678-585-9261
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC003425101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional