Creating Connections Counseling Services Pllc | |
13810 Champion Forest Dr Ste 150 Houston TX 77069-1883 | |
(832) 639-8080 | |
Not Available |
Full Name | Creating Connections Counseling Services Pllc |
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Speciality | Social Worker |
Location | 13810 Champion Forest Dr Ste 150, Houston, Texas |
Authorized Official Name and Position | Doretha Pengel (OWNER) |
Authorized Official Contact | 8326398080 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Creating Connections Counseling Services Pllc 13810 Champion Forest Dr Ste 150 Houston TX 77069-1883 Ph: (832) 639-8080 | Creating Connections Counseling Services Pllc 13810 Champion Forest Dr Ste 150 Houston TX 77069-1883 Ph: (832) 639-8080 |
NPI Number | 1174131569 |
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Provider Enumeration Date | 07/21/2020 |
Last Update Date | 05/04/2021 |
Certification Date | 01/23/2021 |
Medicare PECOS PAC ID | 7618393737 |
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Medicare Enrollment ID | O20200819001448 |
Identifier | Type | State | Issuer |
---|---|---|---|
1174131569 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Doretha Francine Pengel |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1205156809 PECOS PAC ID: 8527484641 Enrollment ID: I20200819001570 |
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