Provider Demographics
NPI:1881944890
Name:MOSSAD, MONA MIKHAIL (LPC)
Entity type:Individual
Prefix:MRS
First Name:MONA
Middle Name:MIKHAIL
Last Name:MOSSAD
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 1:12345 JONES RD
Mailing Address - Street 2:285
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4855
Mailing Address - Country:US
Mailing Address - Phone:281-894-7222
Mailing Address - Fax:281-894-7892
Practice Address - Street 1:12345 JONES RD
Practice Address - Street 2:285
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4855
Practice Address - Country:US
Practice Address - Phone:281-894-7222
Practice Address - Fax:281-894-7892
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-17
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67138101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional