Provider Demographics
NPI:1912189077
Name:HOUSTON, NATASHA (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:HOUSTON
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:MRS
Other - First Name:NATASHA
Other - Middle Name:HOUSTON
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC, NCC
Mailing Address - Street 1:PO BOX 38741
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38183-0741
Mailing Address - Country:US
Mailing Address - Phone:901-270-7361
Mailing Address - Fax:
Practice Address - Street 1:162 E.MILITARY ROAD
Practice Address - Street 2:SUITE B
Practice Address - City:MARION
Practice Address - State:AR
Practice Address - Zip Code:72364
Practice Address - Country:US
Practice Address - Phone:901-270-7361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-30
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
TN3254101YP2500X
ARP1006039101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health