Provider Demographics
NPI:1477074946
Name:AHAVA COUNSELING & MEDIATION PRACTICE, LLC
Entity Type:Organization
Organization Name:AHAVA COUNSELING & MEDIATION PRACTICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:832-715-8306
Mailing Address - Street 1:PO BOX 331675
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77233-1675
Mailing Address - Country:US
Mailing Address - Phone:832-715-8306
Mailing Address - Fax:
Practice Address - Street 1:8300 FM 1960 RD W
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-5654
Practice Address - Country:US
Practice Address - Phone:832-715-8306
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-05
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX74801101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty