Healthcare Provider Details
I. General information
NPI: 1922395011
Provider Name (Legal Business Name): CENTER FOR HEALTHY SEXUALITY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/08/2011
Last Update Date: 07/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2400 AUGUSTA DR SUITE #120
HOUSTON TX
77057-4922
US
IV. Provider business mailing address
2400 AUGUSTA DR SUITE #120
HOUSTON TX
77057-4922
US
V. Phone/Fax
- Phone: 713-785-7111
- Fax: 713-785-2657
- Phone: 713-785-7111
- Fax: 713-785-2657
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | 55159 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | 3473005014 |
| License Number State | TX |
VIII. Authorized Official
Name: DR.
BARBARA
S
LEVINSON
Title or Position: OWNER AND DIRECTOR
Credential: PH.D, RN, LMFT
Phone: 713-785-7111