Provider Demographics
NPI:1841595949
Name:EL CAMINO COUNSELING, PLLC
Entity Type:Organization
Organization Name:EL CAMINO COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JURI
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S
Authorized Official - Phone:713-647-0002
Mailing Address - Street 1:10245 KEMPWOOD DR STE E
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77043-1840
Mailing Address - Country:US
Mailing Address - Phone:713-647-0002
Mailing Address - Fax:713-647-0885
Practice Address - Street 1:5639 HEATHER RUN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77041-6617
Practice Address - Country:US
Practice Address - Phone:713-647-0002
Practice Address - Fax:713-647-0885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-20
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17929101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX154693904Medicaid