Individual
MARK KAKOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCDC
Contact information
Practice address
9918 YEARLING PL, CONROE, TX 77385-2020
(412) 608-4322
Mailing address
9918 YEARLING PL, CONROE, TX 77385-2020
(412) 608-4322
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
14548
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14548
LCDC
TX
Enumeration date
05/23/2021
Last updated
05/23/2021
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