Organization
CONCRETE ROSE COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC S WELLS LPC, LSTOP (PSYCHO-THERAPIST)
(832) 563-8623
Entity
Organization
Contact information
Practice address
1319 LIVE OAK ST, HOUSTON, TX 77003-4408
(832) 563-8623
Mailing address
12806 GLORYWHITE CT, HOUSTON, TX 77034-3685
(832) 563-8623
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
20180
TX
101YA0400X
Addiction (Substance Use Disorder) Counselor
20180
TX
101YM0800X
Mental Health Counselor
20180
TX
101YP2500X
Professional Counselor
Primary
20180
TX
106H00000X
Marriage & Family Therapist
20180
TX
Other
Enumeration date
08/24/2007
Last updated
08/24/2007
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