Provider Demographics
NPI:1174857189
Name:INNOVATIONS COUNSELING AND CONSULTING PLLC
Entity Type:Organization
Organization Name:INNOVATIONS COUNSELING AND CONSULTING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:PAYNE
Authorized Official - Last Name:GLASSER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:281-597-9291
Mailing Address - Street 1:11999 KATY FWY
Mailing Address - Street 2:SUITE 490
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-1611
Mailing Address - Country:US
Mailing Address - Phone:281-597-9291
Mailing Address - Fax:281-597-9761
Practice Address - Street 1:11999 KATY FWY
Practice Address - Street 2:SUITE 490
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-1611
Practice Address - Country:US
Practice Address - Phone:281-597-9291
Practice Address - Fax:281-597-9761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12634101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty