Provider Demographics
NPI:1679683312
Name:PINSON, INGA KENYATTA
Entity Type:Individual
Prefix:
First Name:INGA
Middle Name:KENYATTA
Last Name:PINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3226 LEGENDS CREEK DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-2896
Mailing Address - Country:US
Mailing Address - Phone:713-377-8632
Mailing Address - Fax:832-442-5631
Practice Address - Street 1:3845 CYPRESS CREEK PKWY STE 213
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77068
Practice Address - Country:US
Practice Address - Phone:713-377-8632
Practice Address - Fax:832-442-5631
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX175814602Medicaid