Healthcare Provider Details

I. General information

NPI: 1699362350
Provider Name (Legal Business Name): SULCATA PSYCHIATRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2020
Last Update Date: 02/22/2023
Certification Date: 02/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12075 SPRING CYPRESS RD STE D
TOMBALL TX
77377-8040
US

IV. Provider business mailing address

12075 SPRING CYPRESS RD STE D
TOMBALL TX
77377-8040
US

V. Phone/Fax

Practice location:
  • Phone: 281-747-8588
  • Fax: 281-666-8880
Mailing address:
  • Phone: 281-747-8588
  • Fax: 281-666-8880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: STONI JOHNSTON
Title or Position: OWNER, APRN
Credential: APRN, MSN, PMHNP-BC
Phone: 281-747-8588