Provider Demographics
NPI:1255652855
Name:MONTROSE COUNSELING CENTER, INC.
Entity Type:Organization
Organization Name:MONTROSE COUNSELING CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANN
Authorized Official - Middle Name:J
Authorized Official - Last Name:ROBISON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:713-529-0037
Mailing Address - Street 1:401 BRANARD ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-5015
Mailing Address - Country:US
Mailing Address - Phone:713-529-0037
Mailing Address - Fax:713-526-4367
Practice Address - Street 1:401 BRANARD ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-5015
Practice Address - Country:US
Practice Address - Phone:713-529-0037
Practice Address - Fax:713-526-4367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-17
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX272-272A261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1083347-02Medicaid
00T91AMedicare PIN