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Organization
THE GENESIS WELLNESS CENTER PLLC
Active
Organization
THE GENESIS WELLNESS CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY MCCULLOUGH PHD, LSSP, LPC-S (THERAPIST/OWNER)
(832) 429-4917
Entity
Organization
Contact information
Practice address
11757 KATY FWY STE 1300, HOUSTON, TX 77079-1725
(832) 429-4917
Mailing address
23144 CINCO RANCH BLVD STE B, KATY, TX 77494-2893
(832) 429-4917
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
02/20/2019
Last updated
11/05/2024
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