Lake Conroe Counseling Center, PLLC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

202885 Issued in TX

Legal business name

LAKE CONROE COUNSELING CENTER, PLLC

Doing business as

Lake Conroe Counseling

Practice address

123 Blue Heron Dr Ste 104
Montgomery, TX 77316-3192

Phone

(936) 449-8053

NPI assigned

May 10, 2017

Organization subpart

No

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

Authorized official

Name

Amy R DeanNPI 1740713361

Title

Owner

Phone

(936) 449-8053

Specialties & licenses 1

Addresses

Other names 1

• Lake Conroe Counseling Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Aimee Castillo, LPC ASSOCIATE

  • Professional Counselor
  • Montgomery, TX
  • NPI 1689379216
  Medicare reassignment Care Compare group NPD
• Amy R Dean, LMFT

  • Marriage & Family Therapist
  • Montgomery, TX
  • NPI 1740713361
  Medicare reassignment NPD Authorized official
• Connie Lynn Kramer, M.A., LPC

  • Professional Counselor
  • Montgomery, TX
  • NPI 1528931284
  Medicare reassignment Care Compare group NPD
• Shayla Noel Schmidt, M.A., LPC, LMFT

  • Professional Counselor
  • Montgomery, TX
  • NPI 1275131609

  Marriage & Family Therapist

  Medicare reassignment Care Compare group NPD
• Tiffany Kaye Stout

  • Mental Health Counselor
  • Spring, TX
  • NPI 1346828555
  Medicare reassignment Care Compare group NPD
• Angel Delarosa, M.A.,LPC

  • Professional Counselor
  • Houston, TX
  • NPI 1962897165
  Medicare reassignment NPD
• Jenny Baker

  • Professional Counselor
  • Montgomery, TX
  • NPI 1487222543
  NPD
• Tony Wesley Deramus, DC

  • Sports Physician Chiropractor
  • Montgomery, TX
  • NPI 1750494985
  NPD (past)

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

{
    "created_epoch": "1494374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604880000000",
    "number": "1750817888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 BLUE HERON DR STE 104",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773163192",
            "telephone_number": "936-449-8053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 BLUE HERON DR STE 104",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773163192",
            "telephone_number": "936-449-8053"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15001 Walden Rd",
            "address_2": "Suite 235",
            "address_purpose": "LOCATION",
            "city": "Montgomery",
            "state": "TX",
            "postal_code": "773568578",
            "country_code": "US",
            "telephone_number": "936-449-8053",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LAKE CONROE COUNSELING CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-10",
        "last_updated": "2020-11-09",
        "certification_date": "2020-09-15",
        "status": "A",
        "authorized_official_last_name": "DEAN",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "936-449-8053"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "202885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Conroe Counseling",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lake Conroe Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kroger Texas L P (Kroger Pharmacy)
• Jamie Narendra Kuda, PHARMD
• Wendy Kuo, OD
• Lake Area Emergency Center LLC (Physicians ER Lake Area)
• Lake Area Pediatrics
• Lake Conroe Physical Therapy and Rehabilitation Services, Inc.
• Lakeside Pharmacy LLC (Lakeside Pharmacy)
• Lakeside Pharmacy LLC
• Lakeside Sleep Center LLC
• Wilmot Lambert, RN

• Marriage & Family Therapist in Montgomery, TX
• Providers in Montgomery, TX by specialty
• Marriage & Family Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.