Provider Demographics
NPI:1265230684
Name:BARNES, PHELITRIA MICHELLE (LPC-A)
Entity type:Individual
Prefix:
First Name:PHELITRIA
Middle Name:MICHELLE
Last Name:BARNES
Suffix:
Gender:
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2507 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-1270
Mailing Address - Country:US
Mailing Address - Phone:832-643-7629
Mailing Address - Fax:
Practice Address - Street 1:3131 EASTSIDE ST STE 415
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-1919
Practice Address - Country:US
Practice Address - Phone:281-948-3322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX92289101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health