Provider Demographics
NPI:1659814341
Name:BEACON MENTAL HEALTH & SOCIAL SERVICES, PLLC
Entity Type:Organization
Organization Name:BEACON MENTAL HEALTH & SOCIAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOUSEWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LMFT
Authorized Official - Phone:832-248-4636
Mailing Address - Street 1:5726 SAGAMORE BAY LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-7398
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4101 GREENBRIAR ST
Practice Address - Street 2:SUITE 105C
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-5294
Practice Address - Country:US
Practice Address - Phone:832-248-4636
Practice Address - Fax:866-804-7241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-29
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1826133-01Medicaid