Provider Demographics
NPI:1841586377
Name:COUNSELING CENTER OF MONTGOMERY COUNTY
Entity Type:Organization
Organization Name:COUNSELING CENTER OF MONTGOMERY COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR - S
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S
Authorized Official - Phone:936-444-3546
Mailing Address - Street 1:212 CONROE DR
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77301-1950
Mailing Address - Country:US
Mailing Address - Phone:936-444-3546
Mailing Address - Fax:
Practice Address - Street 1:212 CONROE DR
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77301-1950
Practice Address - Country:US
Practice Address - Phone:936-444-3546
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-23
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61098101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty