=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306700828
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HER WELL CENTER, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/10/2025
-----------------------------------------------------
Last Update Date | 12/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 511 VELASCO ST
-----------------------------------------------------
City | BROOKSHIRE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77423-3212
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-934-8727
-----------------------------------------------------
Fax | 281-533-8182
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 511 VELASCO ST
-----------------------------------------------------
City | BROOKSHIRE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77423-3212
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-934-8727
-----------------------------------------------------
Fax | 281-533-8182
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | CANDICE REYES
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 281-934-8727
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------