1699065037 NPI number — EMERALD VENTURE

Table of content: MRS. KATELYN JANEL LEE LMHC, NCC (NPI 1174809487)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699065037 NPI number — EMERALD VENTURE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EMERALD VENTURE
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:
1699065037
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/19/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 293
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BARKER
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77413-0293
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11602 VETERANS MEMORIAL DR
Provider Second Line Business Practice Location Address:
SUITE E
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77067-2606
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-382-9893
Provider Business Practice Location Address Fax Number:
713-382-9893
Provider Enumeration Date:
04/19/2011

Additional Information

Authorized Official

Authorized Official Last Name:
PHAM
Authorized Official First Name:
A
Authorized Official Middle Name:
Authorized Official Title or Position:
SECRETARY
Authorized Official Telephone Number:
713-382-9893

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com