Provider Demographics
NPI:1740343946
Name:BEACON MENTAL HEALTH & SOCIAL SERVICES
Entity type:Organization
Organization Name:BEACON MENTAL HEALTH & SOCIAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOUSEWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LMFT, LBSW
Authorized Official - Phone:832-248-4636
Mailing Address - Street 1:5726 SAGAMORE BAY LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-7398
Mailing Address - Country:US
Mailing Address - Phone:832-248-4636
Mailing Address - Fax:866-804-7241
Practice Address - Street 1:1010 WAVERLY ST
Practice Address - Street 2:SUITE 101
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-6760
Practice Address - Country:US
Practice Address - Phone:832-248-4636
Practice Address - Fax:866-804-7241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X, 103T00000X, 2084P0805X, 208D00000X
TX31626104100000X
TX5210106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1732695-07Medicaid
TX1525750-04Medicaid