Provider Demographics
NPI:1356017495
Name:MATTOX, CLAUDIA ELISE (LPC-A)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:ELISE
Last Name:MATTOX
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:CLAUDIA
Other - Middle Name:ELISE
Other - Last Name:MAYNARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12327 ADVANCE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-2517
Mailing Address - Country:US
Mailing Address - Phone:713-962-8248
Mailing Address - Fax:
Practice Address - Street 1:27240 HIGHWAY 290
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-4907
Practice Address - Country:US
Practice Address - Phone:409-292-9172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-18
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX85764101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional