Provider Demographics
NPI:1609980341
Name:MACLEOD, ANN LOUISE (LPC)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:LOUISE
Last Name:MACLEOD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:L
Other - Last Name:MACLEOD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 248
Mailing Address - Street 2:
Mailing Address - City:MONT BELVIEU
Mailing Address - State:TX
Mailing Address - Zip Code:77580-0248
Mailing Address - Country:US
Mailing Address - Phone:281-731-2561
Mailing Address - Fax:
Practice Address - Street 1:3730 KIRBY DR
Practice Address - Street 2:SUITE 1200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-3905
Practice Address - Country:US
Practice Address - Phone:713-834-1117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX163504701Medicaid