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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