Provider Demographics
| NPI: | 1578249793 |
|---|---|
| Name: | FAVORX3 COUNSELING & CONSULTING SERVICES, PLLC |
| Entity Type: | Organization |
| Organization Name: | FAVORX3 COUNSELING & CONSULTING SERVICES, PLLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | OWNER |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | DARLENE |
| Authorized Official - Middle Name: | RENEE |
| Authorized Official - Last Name: | KEARNEY |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 832-264-7491 |
| Mailing Address - Street 1: | 2626 S LOOP W STE 174 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | HOUSTON |
| Mailing Address - State: | TX |
| Mailing Address - Zip Code: | 77054-2873 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 832-264-7491 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 2626 S LOOP W STE 174 |
| Practice Address - Street 2: | |
| Practice Address - City: | HOUSTON |
| Practice Address - State: | TX |
| Practice Address - Zip Code: | 77054-2873 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 832-264-7491 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2023-06-22 |
| Last Update Date: | 2023-06-22 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 251B00000X | Agencies | Case Management | |
| No | 251K00000X | Agencies | Public Health or Welfare | |
| No | 251S00000X | Agencies | Community/Behavioral Health | |
| No | 251V00000X | Agencies | Voluntary or Charitable | |
| No | 252Y00000X | Agencies | Early Intervention Provider Agency | |
| No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
| No | 261QM0855X | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health |
| No | 261QP0904X | Ambulatory Health Care Facilities | Clinic/Center | Public Health, Federal |
| No | 261QP2400X | Ambulatory Health Care Facilities | Clinic/Center | Prison Health |
| No | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder |
| No | 302F00000X | Managed Care Organizations | Exclusive Provider Organization | |
| No | 305R00000X | Managed Care Organizations | Preferred Provider Organization | |
| No | 305S00000X | Managed Care Organizations | Point of Service | |
| No | 320800000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Mental Illness | |
| No | 3245S0500X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | Substance Abuse Treatment, Children |
