Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | CA | |
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | H0504101828 | CA |
N | 101YM0800X | Mental Health Counselor | 6801083726 | MI |
N | 101YP1600X | Pastoral Counselor | MD | |
Y | 1041C0700X | Clinical Social Worker | LCS 28197 | CA |
NPI | 1346337656 |
---|---|
Provider Name | Mr. Michael Anton Houston |
First Address | Elk Grove, CA 95758-4151 |
Second Address | Sacramento, CA 95816-3784 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2006 |
Last Update Date | 08/02/2018 |