Provider Demographics
NPI:1881870533
Name:WHOLISTIC CHRISTIAN COUNSELING CENTER
Entity type:Organization
Organization Name:WHOLISTIC CHRISTIAN COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:WASHINGTON
Authorized Official - Last Name:VAUGHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-218-7898
Mailing Address - Street 1:PO BOX 8284
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77288-8284
Mailing Address - Country:US
Mailing Address - Phone:713-218-7898
Mailing Address - Fax:
Practice Address - Street 1:2600 S LOOP W
Practice Address - Street 2:STE. 220
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2653
Practice Address - Country:US
Practice Address - Phone:713-218-7898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-11
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX809302F00000X
TX2994106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No302F00000XManaged Care OrganizationsExclusive Provider OrganizationGroup - Single Specialty