1114310471 NPI number — OUTCOME COUNSELING

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114310471 NPI number — OUTCOME COUNSELING

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OUTCOME COUNSELING
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114310471
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/08/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12000 SAWMILL RD APT 1301
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
THE WOODLANDS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77380-2105
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-844-9200
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
25511 BUDDE RD
Provider Second Line Business Practice Location Address:
CAMERON BLDG., SUITE 501
Provider Business Practice Location Address City Name:
THE WOODLANDS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77380-2080
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-844-9200
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/11/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MURPHEY
Authorized Official First Name:
MELANIE
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
SOLE OWNER
Authorized Official Telephone Number:
817-773-7583

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  38879 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)