Provider Demographics
NPI:1497436018
Name:SIMON SALUM, LORIS (LPC-A)
Entity Type:Individual
Prefix:
First Name:LORIS
Middle Name:
Last Name:SIMON SALUM
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5425 RENWICK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-1505
Mailing Address - Country:US
Mailing Address - Phone:713-621-2890
Mailing Address - Fax:
Practice Address - Street 1:12A N WEST OAK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-2120
Practice Address - Country:US
Practice Address - Phone:713-825-8876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX92138101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional