| The Olive Tree Counseling And Supervision | |
|
12262 Queenston Blvd Ste E Houston TX 77095-5361 | |
| (281) 743-3468 | |
| Not Available |
| Full Name | The Olive Tree Counseling And Supervision |
|---|---|
| Speciality | Social Worker |
| Location | 12262 Queenston Blvd Ste E, Houston, Texas |
| Authorized Official Name and Position | Kristin Carpenter (OWNER) |
| Authorized Official Contact | 2817433468 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Olive Tree Counseling And Supervision 12262 Queenston Blvd Ste E Houston TX 77095-5361 Ph: () - | The Olive Tree Counseling And Supervision 12262 Queenston Blvd Ste E Houston TX 77095-5361 Ph: (281) 743-3468 |
| NPI Number | 1598381956 |
|---|---|
| Provider Enumeration Date | 06/22/2020 |
| Last Update Date | 06/22/2020 |
| Certification Date | 06/22/2020 |
| Medicare PECOS PAC ID | 2365866852 |
|---|---|
| Medicare Enrollment ID | O20200716001935 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598381956 | NPI | - | NPPES |
| 1114160777 | Other | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kristin S Carpenter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114160777 PECOS PAC ID: 3274957766 Enrollment ID: I20200716002341 |
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