Provider Demographics
NPI:1659384949
Name:WELLS, ERIC SHARONE (LPC, MA, MAED)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:SHARONE
Last Name:WELLS
Suffix:
Gender:M
Credentials:LPC, MA, MAED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12806 GLORYWHITE CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77034-3685
Mailing Address - Country:US
Mailing Address - Phone:832-563-8623
Mailing Address - Fax:281-922-6448
Practice Address - Street 1:12806 GLORYWHITE CT
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77034-3685
Practice Address - Country:US
Practice Address - Phone:832-563-8623
Practice Address - Fax:281-922-6448
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20180101Y00000X, 101YA0400X, 101YM0800X, 101YP2500X, 101YS0200X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist