Initiative for Change & Development Counseling Services, PLLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

11387 Issued in TX

Legal business name

INITIATIVE FOR CHANGE & DEVELOPMENT COUNSELING SERVICES, PLLC

Practice address

1300 McGowen St
Houston, TX 77004-1141

Phone

(713) 714-8538

Fax

(713) 714-8841

NPI assigned

Oct 31, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Alan Roy Blackshear, LCDC, CART, COPSD

Title

Director

Phone

(713) 714-8539

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1414713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414713600000",
    "number": "1629473772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 MCGOWEN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770041141",
            "telephone_number": "713-714-8538",
            "fax_number": "713-714-8841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MCGOWEN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770041141",
            "telephone_number": "713-714-8538",
            "fax_number": "713-714-8841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INITIATIVE FOR CHANGE & DEVELOPMENT COUNSELING SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-31",
        "last_updated": "2014-10-31",
        "status": "A",
        "authorized_official_last_name": "BLACKSHEAR",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "ROY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "713-714-8539",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCDC, CART, COPSD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "TX",
            "license": "11387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2014; 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.