Provider Demographics
NPI:1922717867
Name:EKEMODE, HAMDALAT M (LPC-A)
Entity Type:Individual
Prefix:MS
First Name:HAMDALAT
Middle Name:M
Last Name:EKEMODE
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:MS
Other - First Name:DEE
Other - Middle Name:H
Other - Last Name:EKEMODE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC-A
Mailing Address - Street 1:8530 FM 1960 RD E STE 214
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-1831
Mailing Address - Country:US
Mailing Address - Phone:346-297-0405
Mailing Address - Fax:281-688-5968
Practice Address - Street 1:8530 FM 1960 RD E STE 214
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-1831
Practice Address - Country:US
Practice Address - Phone:346-297-0405
Practice Address - Fax:281-688-5968
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-18
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX89065101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX19172OtherLPC-S