Provider Demographics
NPI:1952485575
Name:NASERI, CONNIE JEAN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:CONNIE
Middle Name:JEAN
Last Name:NASERI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3741 RED BLUFF RD
Mailing Address - Street 2:SUITE C315
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77503-3318
Mailing Address - Country:US
Mailing Address - Phone:713-475-0072
Mailing Address - Fax:713-472-8684
Practice Address - Street 1:3741 RED BLUFF RD
Practice Address - Street 2:SUITE C315
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77503-3318
Practice Address - Country:US
Practice Address - Phone:713-475-0072
Practice Address - Fax:713-472-8684
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12924101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional