Healthcare Provider Details

I. General information

NPI: 1487567897
Provider Name (Legal Business Name): SAFE PLACE THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 SANDIA PLZ
BRYAN TX
77802-4356
US

IV. Provider business mailing address

1401 SANDIA PLZ
BRYAN TX
77802-4356
US

V. Phone/Fax

Practice location:
  • Phone: 903-204-4023
  • Fax:
Mailing address:
  • Phone: 903-204-4023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: MARY WALKER
Title or Position: OWNER
Credential: LPC
Phone: 903-644-1510