KINGHAVEN COUNSELING GROUP INC NPI 1396807350

NPI Information

NPI: 1396807350
Provider Name: KINGHAVEN COUNSELING GROUP INC
Classification: Counselor - 101YP2500X
Entity Type: Organization

Specialization: Professional

CLIA Number: 45D2044533

Address:
6315 GULFTON ST
SUITE 100
HOUSTON, TX
ZIP 77081
Phone: (713) 457-4372
Get Directions

KINGHAVEN COUNSELING GROUP INC is a professional counselor in Houston, TX. KINGHAVEN COUNSELING GROUP INC NPI is 1396807350. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

6315 GULFTON ST
SUITE 100
HOUSTON, TX
ZIP 77081-107
Phone: (713) 457-4372
Fax: (713) 457-0945

The provider's authorized official is Shegun Olagundoye .
The authorized official title is Cfo and has the following contact phone number (713) 457-4372.

The CLIA number assigned to this NPI record is 45D2044533 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/15/2006 and was last updated on 11/12/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License State	Primary
1	101YM0800X	Counselor	Mental Health		No
2	103G00000X	Clinical Neuropsychologist			No
3	103T00000X	Psychologist			No
4	103TA0400X	Psychologist	Addiction (Substance Use Disorder)		No
5	103TA0700X	Psychologist	Adult Development & Aging		No
6	103TC2200X	Psychologist	Clinical Child & Adolescent		No
7	103TP2701X	Psychologist	Group Psychotherapy		No
8	1041C0700X	Social Worker	Clinical		No
9	106H00000X	Marriage & Family Therapist			No
10	106S00000X	Behavior Technician			No
11	2084P0800X	Psychiatry & Neurology	Psychiatry		No
12	261QM1300X	Clinic/Center	Multi-Specialty		No
13	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	TEXAS	No
14	101YP2500X	Counselor	Professional		Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	3496-3497	OTHER	TEXAS	SUBSTANCE ABUSE FACILITY
2	158284301	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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