Provider Demographics
NPI:1922577485
Name:MCCOMB, CHARLES HUSTON JR (LPC-S, CSAT, CMAT)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:HUSTON
Last Name:MCCOMB
Suffix:JR
Gender:M
Credentials:LPC-S, CSAT, CMAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 841665
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-0020
Mailing Address - Country:US
Mailing Address - Phone:281-813-7360
Mailing Address - Fax:
Practice Address - Street 1:6009 RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-6226
Practice Address - Country:US
Practice Address - Phone:281-813-7360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-14
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62699101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health