Provider Demographics
NPI:1750300299
Name:PICKER, JON SIMON (LPC)
Entity Type:Individual
Prefix:MR
First Name:JON
Middle Name:SIMON
Last Name:PICKER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 NOBLE ST
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77373-8339
Mailing Address - Country:US
Mailing Address - Phone:281-583-0112
Mailing Address - Fax:281-292-2787
Practice Address - Street 1:326 NOBLE ST
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77373-8339
Practice Address - Country:US
Practice Address - Phone:281-583-0112
Practice Address - Fax:281-288-5807
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX785101YA0400X
TX08862101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXLP 0000300Medicaid