Provider Demographics
NPI:1710228655
Name:TRAN, QUOC DUNG (LPC, LCDC)
Entity Type:Individual
Prefix:MR
First Name:QUOC DUNG
Middle Name:
Last Name:TRAN
Suffix:
Gender:M
Credentials:LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20114 GREAT LAKE ST
Mailing Address - Street 2:
Mailing Address - City:WALLER
Mailing Address - State:TX
Mailing Address - Zip Code:77484-7085
Mailing Address - Country:US
Mailing Address - Phone:832-594-1895
Mailing Address - Fax:
Practice Address - Street 1:20114 GREAT LAKE ST
Practice Address - Street 2:
Practice Address - City:WALLER
Practice Address - State:TX
Practice Address - Zip Code:77484-7085
Practice Address - Country:US
Practice Address - Phone:832-594-1895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-01
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17239101YA0400X
TX67871101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)