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General NPI Number Information
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NPI Number | 1376313619
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Entity Type | Organization
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Legal Business Name | NORTH STAR CHILD AND FAMILY THERAPY, PLLC
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Dates
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Enumeration Date | 01/08/2024
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Last Update Date | 03/21/2024
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Provider Practice Location Address
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Address Line | 33130 MAGNOLIA CIR STE A21
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City | MAGNOLIA
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State | TX
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Zip | 77354-3277
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Country | US
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Telephone | 281-789-8677
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Fax |
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Provider Business Mailing Address
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Address Line | 33130 MAGNOLIA CIR STE A
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City | MAGNOLIA
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State | TX
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Zip | 77354-4169
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Country | US
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Telephone | 281-789-8667
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | JENESSA LOUISE RIVAS
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Credential | LPC-A
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Telephone | 281-789-8677
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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