1841878279 NPI number — THERAPEUTIC COUNSELING AND WELLNESS PLLC

Table of content: (NPI 1841878279)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841878279 NPI number — THERAPEUTIC COUNSELING AND WELLNESS PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THERAPEUTIC COUNSELING AND WELLNESS PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841878279
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/29/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3 SUGAR CREEK CENTER BLVD STE 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SUGAR LAND
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77478-2211
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-810-3000
Provider Business Mailing Address Fax Number:
713-936-2784

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3 SUGAR CREEK CENTER BLVD STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SUGAR LAND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77478-2211
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-810-3000
Provider Business Practice Location Address Fax Number:
713-936-2784
Provider Enumeration Date:
03/29/2021

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PATE
Authorized Official First Name:
KIMBERLY
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
281-810-3000

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 347873704 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 347873705 . This is a "CSN-MEDICAID" identifier . This identifiers is of the category "OTHER".