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General NPI Number Information
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NPI Number | 1003477530
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Entity Type | Organization
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Legal Business Name | TRADE IT IN
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Dates
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Enumeration Date | 06/25/2019
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Last Update Date | 07/01/2022
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Provider Practice Location Address
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Address Line | 6201 BONHOMME RD # 430N
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City | HOUSTON
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State | TX
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Zip | 77036-4365
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Country | US
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Telephone | 832-975-0000
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Fax | 832-582-3688
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Provider Business Mailing Address
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Address Line | 6201 BONHOMME RD # 430N
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City | HOUSTON
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State | TX
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Zip | 77036-4365
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Country | US
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Telephone | 832-975-0000
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Fax | 832-582-3688
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Authorized Official
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Title or Position | CEO
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Name | DR. KATRINA A. GARY-FORTE
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Credential | PH.D.
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Telephone | 832-975-0000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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