1013028059 NPI number — MRS. JANICE ELAINE COSTA LPC LMFT

Table of content: MRS. JANICE ELAINE COSTA LPC LMFT (NPI 1013028059)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013028059 NPI number — MRS. JANICE ELAINE COSTA LPC LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COSTA
Provider First Name:
JANICE
Provider Middle Name:
ELAINE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LPC LMFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
COSTA
Provider Other First Name:
JANICE
Provider Other Middle Name:
KELLEY
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LPC LMFT
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1013028059
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2702 WOODS ESTATES DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KINGWOOD
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77339
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-358-4371
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
22999 US HWY 59
Provider Second Line Business Practice Location Address:
SUITE 274
Provider Business Practice Location Address City Name:
KINGWOOD
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77339
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-348-3320
Provider Business Practice Location Address Fax Number:
281-348-3303
Provider Enumeration Date:
08/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X , with the licence number:  7338 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 106H00000X , with the licence number: 1694 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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





Copyright © 2007-2025 www.npivalidator.com