Provider Demographics
NPI:1649993429
Name:EMADI, NINA (MS, LPC, NCC)
Entity type:Individual
Prefix:
First Name:NINA
Middle Name:
Last Name:EMADI
Suffix:
Gender:F
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:SEYEDEH
Other - Middle Name:NINA
Other - Last Name:EMADI RAZAVI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18506 GREEN LAND WAY STE A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-5194
Mailing Address - Country:US
Mailing Address - Phone:713-316-9081
Mailing Address - Fax:281-377-6059
Practice Address - Street 1:701 N POST OAK RD STE 117
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-3839
Practice Address - Country:US
Practice Address - Phone:713-316-9081
Practice Address - Fax:281-377-6059
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-26
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX85135101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX41637931OtherTX DRIVER LICENSE