Organization
WATERSHED COUNSELING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LARISA JEANNINE LOERA (PRESIDENT / OWNER)
(936) 297-5252
Entity
Organization
Contact information
Practice address
14855 LIBERTY ST, MONTGOMERY, TX 77356-4631
(936) 297-5252
Mailing address
14855 LIBERTY ST, MONTGOMERY, TX 77356-4631
(936) 297-5252
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
101YP1600X
Pastoral Counselor
—
—
101YP2500X
Professional Counselor
—
—
103TC1900X
Counseling Psychologist
—
—
156F00000X
Technician/Technologist
—
—
Other
Enumeration date
07/24/2023
Last updated
07/24/2023
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