Provider Demographics
NPI:1144339524
Name:GREATHOUSE, JONNIE BEBE (LPC AAC)
Entity type:Individual
Prefix:MS
First Name:JONNIE
Middle Name:BEBE
Last Name:GREATHOUSE
Suffix:
Gender:F
Credentials:LPC AAC
Other - Prefix:
Other - First Name:BEBE
Other - Middle Name:
Other - Last Name:GREATHOUSE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC AAC
Mailing Address - Street 1:6262 WEBER RD
Mailing Address - Street 2:SSUITE 210
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-4031
Mailing Address - Country:US
Mailing Address - Phone:361-991-2214
Mailing Address - Fax:361-225-3225
Practice Address - Street 1:6262 WEBER RD
Practice Address - Street 2:SSUITE 210
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-4031
Practice Address - Country:US
Practice Address - Phone:361-991-2214
Practice Address - Fax:361-225-3225
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14531000101YA0400X
TX11042101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional