=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407736697
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FAITH THERAPY AND WELLNESS PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/06/2025
-----------------------------------------------------
Last Update Date | 09/06/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 32903 S RED LEAF LN
-----------------------------------------------------
City | BROOKSHIRE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77423-9185
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-378-8434
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 32903 S RED LEAF LN
-----------------------------------------------------
City | BROOKSHIRE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77423-9185
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-378-8434
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | FAITH MARIE FORERO
-----------------------------------------------------
Credential | LCSW LCDC
-----------------------------------------------------
Telephone | 281-774-8155
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------