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General NPI Number Information
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NPI Number | 1841892551
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Entity Type | Organization
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Legal Business Name | UNCHARTED TERRITORY MENTAL HEALTH PLLC
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Dates
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Enumeration Date | 11/09/2020
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Last Update Date | 11/09/2020
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Provider Practice Location Address
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Address Line | 507 N SAM HOUSTON PKWY E STE 165
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City | HOUSTON
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State | TX
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Zip | 77060-4081
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Country | US
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Telephone | 832-546-0643
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Fax |
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Provider Business Mailing Address
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Address Line | 23126 BAYLEAF DR
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City | SPRING
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State | TX
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Zip | 77373-6486
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Country | US
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Telephone | 318-268-5619
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | WILLIAM JEMAL HILL
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Credential | PMHNP-BC
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Telephone | 832-546-0643
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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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 | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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