Provider Demographics
NPI:1447968656
Name:JAIN, ANUGEETIKA (LPC)
Entity type:Individual
Prefix:
First Name:ANUGEETIKA
Middle Name:
Last Name:JAIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:ANUGEETIKA
Other - Middle Name:
Other - Last Name:JAIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SHELLY
Mailing Address - Street 1:18333 EGRET BAY BLVD STE 270M
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-3860
Mailing Address - Country:US
Mailing Address - Phone:281-333-2817
Mailing Address - Fax:
Practice Address - Street 1:18333 EGRET BAY BLVD STE 270M
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3860
Practice Address - Country:US
Practice Address - Phone:281-333-2817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-08
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78017101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX78017OtherLPC