Individual provider · Type 1 NPI

Jackiethsha Fluellen-Lake

Professional Counselor · Houston, TX

NPI number 1265340517 Active

Practice location

3730 Kirby Dr Ste 904
Houston, TX 77098-3994

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500X95829 (TX)

Professional Counselor: Definition to come...

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About NPI 1265340517

Jackiethsha Fluellen-Lake's National Provider Identifier is 1265340517, issued on Aug 28, 2026. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Houston, TX. The record was last updated on Aug 28, 2026.