Center for Pain Rehabilitation, PA

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

62953 Issued in TX

Legal business name

CENTER FOR PAIN REHABILITATION, PA

Practice address

8200 Wednesbury LN Ste 210
Houston, TX 77074-2931

Phone

(713) 771-2225

Fax

(713) 771-1876

NPI assigned

Dec 9, 2013

Organization subpart

Yes

Parent organization

ICH HEALTHCARE, PAAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Carey Jackson, LPC

Title

Executive

Phone

(713) 771-2225

Specialties & licenses 1

Addresses

Part of

Ich Healthcare PA

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1386547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386547200000",
    "number": "1356772925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8200 WEDNESBURY LN STE 210",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770742931",
            "telephone_number": "713-771-2225",
            "fax_number": "713-771-1876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 WEDNESBURY LN STE 210",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770742931",
            "telephone_number": "713-771-2225",
            "fax_number": "713-771-1876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR PAIN REHABILITATION, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ICH HEALTHCARE, PA",
        "enumeration_date": "2013-12-09",
        "last_updated": "2013-12-09",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "CAREY",
        "authorized_official_title_or_position": "EXECUTIVE",
        "authorized_official_telephone_number": "713-771-2225",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "62953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Houston, TX
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• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.