=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609587641
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CLINIAPY HELPING HOUSE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/12/2022
-----------------------------------------------------
Last Update Date | 01/06/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4324 MAPLESHADE LN STE 234
-----------------------------------------------------
City | PLANO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75093-0044
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 469-990-2133
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4324 MAPLESHADE LN STE 234
-----------------------------------------------------
City | PLANO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75093-0044
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 469-554-9485
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | FOUNDER/CEO
-----------------------------------------------------
Name | MR. RAYMOND EARLE BRYANT JR.
-----------------------------------------------------
Credential | LMSW
-----------------------------------------------------
Telephone | 469-990-2133
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0801X
-----------------------------------------------------
Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------