Healthcare Provider Details
I. General information
NPI: 1285114454
Provider Name (Legal Business Name): PSYCH MATTERS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/17/2018
Last Update Date: 03/01/2022
Certification Date: 03/01/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4801 WOODWAY DR STE 306W
HOUSTON TX
77056-1828
US
IV. Provider business mailing address
4801 WOODWAY DR STE 306W
HOUSTON TX
77056-1828
US
V. Phone/Fax
- Phone: 832-225-3345
- Fax:
- Phone: 832-225-3345
- Fax: 713-583-1504
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084N0400X |
| Taxonomy | Neurology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANDREW
MATTERN
Title or Position: OWNER
Credential: LPC
Phone: 832-439-6320