Provider Demographics
NPI:1851534218
Name:ADDICTION COUNSELING ASSOCIATES
Entity Type:Organization
Organization Name:ADDICTION COUNSELING ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:BLANCHE
Authorized Official - Middle Name:HANDUNGE
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:713-520-5492
Mailing Address - Street 1:19315 MORNING NEWS LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-2996
Mailing Address - Country:US
Mailing Address - Phone:713-520-5492
Mailing Address - Fax:713-365-0133
Practice Address - Street 1:2990 RICHMOND AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-3104
Practice Address - Country:US
Practice Address - Phone:713-520-5492
Practice Address - Fax:713-365-0133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-15
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13025101Y00000X, 101YM0800X, 101YP2500X, 103TP2701X
TX5660101YA0400X, 103TA0400X
101YP1600X, 103T00000X, 103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Single Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Single Specialty
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensicGroup - Single Specialty
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX026718902Medicaid