Healthcare Provider Details

I. General information

NPI: 1053023960
Provider Name (Legal Business Name): PSYCH MATTERS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2022
Last Update Date: 12/22/2022
Certification Date: 12/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 BROADWAY SUITE 3047
NEW YORK NY
10018
US

IV. Provider business mailing address

4801 WOODWAY DR STE 306W
HOUSTON TX
77056-1828
US

V. Phone/Fax

Practice location:
  • Phone: 917-994-0057
  • Fax: 713-583-1504
Mailing address:
  • Phone: 832-225-3345
  • Fax: 713-583-1504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MONICA R. STAHL
Title or Position: MANAGING PARTNER
Credential:
Phone: 832-332-3703