MEDICARE: AMPLIFY PLUS THERAPY & COACHING PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
2	1041C0700X	Clinical Social Worker

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	60118	OTHER	TX	TEXAS STATE BOARD OF SOCIAL WORKER EXAMINERS
2	14238488	OTHER		CAQH

General Provider Information

NPI Number	:	1144897497
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMPLIFY PLUS THERAPY & COACHING PLLC

Provider Business Mailing Address
First Line	:	4220 CARTWRIGHT RD STE 105
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-5307
Country	:	US
Telephone Number	:	346-341-7971
Fax Number	:

Provider Business Practice Location Address
First Line	:	2706 LAKE VILLA DR
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-7650
Country	:	US
Telephone Number	:	281-782-1641
Fax Number	:	281-969-7259

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JAMES W BAILEY
Credential	:	PHD, LCSWS
Telephone Number	:	346-341-7971

Provider Enumeration Date	:	06/07/2021
Last Update Date	:	02/03/2023

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