Active NPI
Clarissa M Bourgeois, M.ED, LPC
- Professional Counselor
- Houston, TX
National Provider Identifier
1194354589
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 75074
- Practice address
- 19500 State Highway 249 Ste 120
Houston, TX 77070-3027 - Phone
- (844) 824-8775
- NPI assigned
- Apr 7, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 75074 | TX | |
| Professional Counselor | 101YP2500X | 75074 | TX | Primary |
Addresses
Primary practice location
19500 State Highway 249 Ste 120
Houston, TX 77070-3027
Mailing address
308 S Friendswood Dr Ste 200
Friendswood, TX 77546-3989
Phone (844) 824-8775
Other practice location 1
2103 Research Forest Dr Ste 175
The Woodlands, TX 77380-4162
Phone (844) 824-8775
Other names 1
- Clarissa Urban
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 75074 | TX | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715558400000",
"number": "1194354589",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "308 S FRIENDSWOOD DR STE 200",
"city": "FRIENDSWOOD",
"state": "TX",
"postal_code": "775463989",
"telephone_number": "844-824-8775"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19500 STATE HIGHWAY 249 STE 120",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770703027",
"telephone_number": "844-824-8775"
}
],
"practiceLocations": [
{
"address_1": "2103 Research Forest Dr Ste 175",
"address_purpose": "LOCATION",
"city": "The Woodlands",
"state": "TX",
"postal_code": "773804162",
"country_code": "US",
"telephone_number": "844-824-8775",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BOURGEOIS",
"first_name": "CLARISSA",
"middle_name": "M",
"credential": "M.ED, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-04-07",
"last_updated": "2024-05-13",
"certification_date": "2024-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "75074",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "75074",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CLARISSA",
"last_name": "URBAN",
"credential": "LPC",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.