Provider Demographics
NPI:1841569837
Name:FORDJOUR, PAUL WYCLIFF (LMFT)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:WYCLIFF
Last Name:FORDJOUR
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10903 HIGHLAND MEADOW VLG DR
Mailing Address - Street 2:405
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089-5388
Mailing Address - Country:US
Mailing Address - Phone:281-824-2373
Mailing Address - Fax:
Practice Address - Street 1:10903 HIGHLAND MEADOW VLG DR
Practice Address - Street 2:405
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089-5388
Practice Address - Country:US
Practice Address - Phone:281-824-2373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-20
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11143104100000X
TX2989106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No104100000XBehavioral Health & Social Service ProvidersSocial Worker