# FOURTH DIMENSION COUNSELING SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891187910
- **Authorized official:** MR. CARL MICHAEL POOLE LCDC (CEO)
- **Authorized official phone:** (832) 581-2970

## Contact information

- **Practice address:** 2616 S LOOP W, SUITE 655, HOUSTON, TX 77054-2662
- **Practice address phone:** (832) 581-2970
- **Mailing address:** 2616 S LOOP W, SUITE 655, HOUSTON, TX 77054-2662
- **Mailing address phone:** (832) 581-2970

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 3830-3831 | TX | Yes |
| 302R00000X | Health Maintenance Organization | 3830-3831 | TX | — |
| 305R00000X | Preferred Provider Organization | 3830-3831 | TX | — |
| 305S00000X | Point of Service | 3830-3831 | TX | — |

## Other

- **Enumeration date:** 02/26/2015
- **Last updated:** 02/26/2015