Organization
THE ADOLESCENT CENTER AND MENTAL HEALTH SERVICES, PLLC
Active
Organization
THE ADOLESCENT CENTER AND MENTAL HEALTH SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VALERIE DARICE JACKSON (CEO)
(832) 484-2635
Entity
Organization
Contact information
Practice address
3730 KIRBY DR STE 904, HOUSTON, TX 77098-3994
(832) 484-2635
(832) 202-2479
Mailing address
3730 KIRBY DR STE 904, HOUSTON, TX 77098-3994
(832) 484-2635
(832) 202-2479
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
—
—
103TC1900X
Counseling Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
345752501
—
TX
Enumeration date
01/26/2015
Last updated
04/11/2018
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