Provider Demographics
NPI:1447281167
Name:SUTHERLAND, BYRON STEPHEN (LPC)
Entity type:Individual
Prefix:MR
First Name:BYRON
Middle Name:STEPHEN
Last Name:SUTHERLAND
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:MR
Other - First Name:STEVE
Other - Middle Name:
Other - Last Name:SUTHERLAND
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:PO BOX 86
Mailing Address - Street 2:
Mailing Address - City:LIVERPOOL
Mailing Address - State:TX
Mailing Address - Zip Code:77577-0086
Mailing Address - Country:US
Mailing Address - Phone:281-794-7414
Mailing Address - Fax:281-997-8866
Practice Address - Street 1:1421 STONE RD
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-8073
Practice Address - Country:US
Practice Address - Phone:281-794-7414
Practice Address - Fax:281-997-8866
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16974101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional