Individual
MR. DUDLEY T FARENTHOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCDC LPC LCSW
Contact information
Practice address
5331 W OREM DR, HOUSTON, TX 77045-5036
(713) 433-0528
(832) 539-1299
Mailing address
PO BOX 451485, HOUSTON, TX 77245-1485
(713) 433-0528
(832) 539-1299
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCDC 797
TX
101YP2500X
Professional Counselor
14943
TX
1041C0700X
Clinical Social Worker
Primary
LCSW 23834
TX
171M00000X
Case Manager/Care Coordinator
23834 LCSW
TX
Other
Enumeration date
12/27/2006
Last updated
03/03/2014
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