Provider Demographics
NPI:1114390531
Name:BELCON, ELIZABETH (LPC, LMFT-ASSOCIATE)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:BELCON
Suffix:
Gender:F
Credentials:LPC, LMFT-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24420 FM 1314 RD, SUITE, 15
Mailing Address - Street 2:
Mailing Address - City:PORTER
Mailing Address - State:TX
Mailing Address - Zip Code:77365
Mailing Address - Country:US
Mailing Address - Phone:281-601-1757
Mailing Address - Fax:
Practice Address - Street 1:24420 FM 1314 RD
Practice Address - Street 2:SUITE 15
Practice Address - City:PORTER
Practice Address - State:TX
Practice Address - Zip Code:77365
Practice Address - Country:US
Practice Address - Phone:281-601-1757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-06
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71650101Y00000X
TX202182101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor