Provider Demographics
NPI:1467827790
Name:OSBORNE, MELODY CELESTE (LPC)
Entity Type:Individual
Prefix:
First Name:MELODY
Middle Name:CELESTE
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5206 FM 1960 RD W STE 103
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77069-4405
Mailing Address - Country:US
Mailing Address - Phone:832-289-2560
Mailing Address - Fax:
Practice Address - Street 1:5206 FM 1960 RD W STE 103
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069-4405
Practice Address - Country:US
Practice Address - Phone:832-289-2560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-11
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72016101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional