# MENTAL ASPECTS BEHAVIORAL HEALTH CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760141733
- **Authorized official:** RENEE LICORISH APRN (OWNER)
- **Authorized official phone:** (210) 475-3617

## Contact information

- **Practice address:** 12702 TOEPPERWEIN RD STE 236, LIVE OAK, TX 78233-3231
- **Practice address phone:** (210) 475-3617
- **Mailing address:** 12702 TOEPPERWEIN RD STE 236, LIVE OAK, TX 78233-3231
- **Mailing address phone:** (210) 475-3617

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 12/16/2021
- **Last updated:** 12/16/2021