Kassandra Humphress, LPC
Individual provider Active NPI Professional Counselor · Conre, TX
NPI 1275818262 · NPPES record last updated Oct 21, 2011
Key facts
- NPI
- 1275818262
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 65603 (TX)
- Practice address
- 100 Interstate 45 North
Ste 124
Conre, TX 77301-2701 - Phone
- (936) 441-3555
- Fax
- (936) 756-3555
- NPI assigned
- Oct 21, 2011
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 65603 | TX | MD | Home Health Certified Respiratory Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 65603 | TX | Yes |
Addresses
Primary practice location
100 Interstate 45 North
Ste 124
Conre, TX 77301-2701
Mailing address
578 Roanoke Dr
Conroe, TX 77302-3779
Phone (936) 273-2021
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 21, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.