Individual provider Active NPI

Elizabeth Betty Divine, LPC, LCDC

  • Addiction (Substance Use Disorder) Counselor
  • Houston, TX
National Provider Identifier
1821167842
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LCDC8902 Issued in TX
Practice address
4803 San Felipe St
Houston, TX 77056-3907
Phone
(713) 626-7990
Fax
(713) 627-7715
NPI assigned
Nov 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCDC8902 TX Primary
Mental Health Counselor 101YM0800X LPC17841 TX

Addresses

Primary practice location

4803 San Felipe St
Houston, TX 77056-3907

Mailing address

5855 Doliver Dr
Houston, TX 77057-2474
Phone (713) 857-7755

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LCDC8902TXMDAddiction (Substance Use Disorder) Counselor
LPC17841TXMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Interface-Samaritan Counseling Centers Mental Health Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1821167842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5855 DOLIVER DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770572474",
            "telephone_number": "713-857-7755",
            "fax_number": "713-627-7715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4803 SAN FELIPE ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770563907",
            "telephone_number": "713-626-7990",
            "fax_number": "713-627-7715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIVINE",
        "first_name": "ELIZABETH",
        "middle_name": "BETTY",
        "credential": "LPC, LCDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "LCDC8902",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "LPC17841",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Sep 11, 2025; 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.