Provider Demographics
NPI:1548570963
Name:MALCOLM-HOANG, CARLY (MA, LPC)
Entity Type:Individual
Prefix:
First Name:CARLY
Middle Name:
Last Name:MALCOLM-HOANG
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1941 EAST RD
Mailing Address - Street 2:SUITE 1236
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-6010
Mailing Address - Country:US
Mailing Address - Phone:713-486-2832
Mailing Address - Fax:713-486-2807
Practice Address - Street 1:1941 EAST RD
Practice Address - Street 2:SUITE 1236
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-6010
Practice Address - Country:US
Practice Address - Phone:713-486-2832
Practice Address - Fax:713-486-2807
Is Sole Proprietor?:No
Enumeration Date:2010-10-19
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62763101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional