Provider Demographics
NPI:1043063019
Name:OBICHUKU, CHIGOZIE EDNAH (LPC)
Entity type:Individual
Prefix:MS
First Name:CHIGOZIE
Middle Name:EDNAH
Last Name:OBICHUKU
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:CHI
Other - Middle Name:
Other - Last Name:OBI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:12325 SHADOW CREEK PKWY APT 113
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7373
Mailing Address - Country:US
Mailing Address - Phone:830-339-2498
Mailing Address - Fax:
Practice Address - Street 1:11100 SOUTHWEST FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77031-3602
Practice Address - Country:US
Practice Address - Phone:346-219-0434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX86943101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional