MEDICARE: PC BARSEEGIAH THERAPUETIC NEST, 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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1184295479
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PC BARSEEGIAH THERAPUETIC NEST, PLLC

Provider Business Mailing Address
First Line	:	19847 RUSTIC LAKE LN
Second Line	:
City	:	CYPRESS
State	:	TX
Zip	:	77433-1759
Country	:	US
Telephone Number	:	346-397-4585
Fax Number	:

Provider Business Practice Location Address
First Line	:	19847 RUSTIC LAKE LN
Second Line	:
City	:	CYPRESS
State	:	TX
Zip	:	77433-1759
Country	:	US
Telephone Number	:	346-397-4585
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR/LPC
Name	:	MARYEHDIAH GIAH
Credential	:	LPC
Telephone Number	:	346-397-4585

Provider Enumeration Date	:	07/07/2021
Last Update Date	:	07/07/2021

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