Healthcare Provider Details

I. General information

NPI: 1023595386
Provider Name (Legal Business Name): MOTION BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2018
Last Update Date: 08/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6548 SPRINGFIELD AVE NUM 202
LAREDO TX
78041
US

IV. Provider business mailing address

6548 SPRINGFIELD AVE NUM 202
LAREDO TX
78041
US

V. Phone/Fax

Practice location:
  • Phone: 956-267-9141
  • Fax: 956-290-8297
Mailing address:
  • Phone: 956-267-9141
  • Fax: 956-290-8297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberL6426
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberL6426
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL HERNANDEZ
Title or Position: MD
Credential: MD
Phone: 956-267-9141