Provider Demographics
NPI:1164704060
Name:HASSAN, FARAH NAZ (MA,LPC)
Entity Type:Individual
Prefix:
First Name:FARAH
Middle Name:NAZ
Last Name:HASSAN
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 1:636 S PEEK RD
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-3186
Mailing Address - Country:US
Mailing Address - Phone:346-387-9463
Mailing Address - Fax:832-787-1185
Practice Address - Street 1:636 S PEEK RD
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-3186
Practice Address - Country:US
Practice Address - Phone:346-387-9463
Practice Address - Fax:832-787-1185
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-16
Last Update Date:2020-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83352101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional