Organization
PSYCH ETCETERA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REGINALD GRAVES MSN-PMHNP (MANAGING MEMBER)
(713) 927-0145
Entity
Organization
Contact information
Practice address
5900 BALCONES DR STE 100, AUSTIN, TX 78731-4298
(713) 927-0145
Mailing address
8600 N FM 620 RD APT 2335, AUSTIN, TX 78726-3569
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
10/08/2021
Last updated
10/08/2021
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