Provider Demographics
NPI:1629558929
Name:HOUSTON, PATRICE MERCYNE (MA, LPC-S, LCDC)
Entity Type:Individual
Prefix:MRS
First Name:PATRICE
Middle Name:MERCYNE
Last Name:HOUSTON
Suffix:
Gender:F
Credentials:MA, LPC-S, LCDC
Other - Prefix:MS
Other - First Name:PATRICE
Other - Middle Name:MERCYNE
Other - Last Name:PHILLIPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 58084
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-8084
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16821 BUCCANEER LN STE 119
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2512
Practice Address - Country:US
Practice Address - Phone:281-630-4825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-16
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7688101YA0400X
TX19665101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)