Provider Demographics
NPI:1770190100
Name:SENFTLEBER-MAKOPOULOS, AMY (R-DMT, LPC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:SENFTLEBER-MAKOPOULOS
Suffix:
Gender:F
Credentials:R-DMT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3131 WEST LOOP S APT 529
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-6138
Mailing Address - Country:US
Mailing Address - Phone:904-631-7536
Mailing Address - Fax:
Practice Address - Street 1:3131 WEST LOOP S APT 529
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-6138
Practice Address - Country:US
Practice Address - Phone:904-631-7536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-29
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX79315101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty