Organization
ETHEL ROW, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONNIE OTIS WASHINGTON JR. (OWNER/EXECUTIVE DIRECTOR)
(713) 909-9247
Entity
Organization
Contact information
Practice address
1 HERMANN PARK COURT, UNIT 645, HOUSTON, TX 77021
(713) 909-9247
Mailing address
PO BOX 300116, HOUSTON, TX 77230-0116
(713) 909-9247
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
101YS0200X
School Counselor
—
—
103T00000X
Psychologist
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TA0700X
Adult Development & Aging Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TF0000X
Family Psychologist
—
—
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
—
103TP0016X
Prescribing (Medical) Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0
—
TX
Enumeration date
08/05/2018
Last updated
08/05/2018
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