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Organization
MIND, BODY & SOUL
Active
Organization
MIND, BODY & SOUL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMEKA NICHOLE BIRTS (CHIEF OPERATING OFFICER)
(770) 873-0087
Entity
Organization
Contact information
Practice address
1400 BROADFIELD BLVD STE 200, HOUSTON, TX 77084-5162
(281) 906-7134
(281) 612-1160
Mailing address
1400 BROADFIELD BLVD,, SUITE 200, HOUSTON, TX 77084-5162
(281) 906-7134
(281) 612-1160
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
08/25/2010
Last updated
03/17/2018
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