Provider Demographics
NPI:1598906331
Name:HASSAN, MAMOONA KHAN (MA LPC)
Entity Type:Individual
Prefix:MRS
First Name:MAMOONA
Middle Name:KHAN
Last Name:HASSAN
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 1:4413 ROCK SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-3478
Mailing Address - Country:US
Mailing Address - Phone:972-816-0042
Mailing Address - Fax:
Practice Address - Street 1:2222 W SPRING CREEK PKWY
Practice Address - Street 2:SUITE 116
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-4183
Practice Address - Country:US
Practice Address - Phone:972-964-3214
Practice Address - Fax:972-964-3044
Is Sole Proprietor?:No
Enumeration Date:2009-03-06
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17249101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional