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NPI Code Detail

MEDICARE: SALTY SUNSHINE

MEDICARE: SALTY SUNSHINE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2104100000XSocial Worker
31041C0700XClinical Social Worker

General Provider Information

NPI Number : 1235902529
Entity Type Code : Organization
Provider Name (Legal Business Name) : SALTY SUNSHINE
Provider Business Mailing Address
First Line : 11311 ATWELL DR
Second Line :
City : HOUSTON
State : TX
Zip : 77035-2615
Country : US
Telephone Number : 806-584-7916
Fax Number :
Provider Business Practice Location Address
First Line : 4306 YOAKUM BLVD STE 510
Second Line :
City : HOUSTON
State : TX
Zip : 77006-5884
Country : US
Telephone Number : 346-437-0777
Fax Number :
Authorized Official
Title or Position : OWNER
Name : JULIET-DANIELLE LANE
Credential : LCSW
Telephone Number : 806-584-7916
Provider Enumeration Date : 10/30/2023
Last Update Date : 10/30/2023

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Directions to “SALTY SUNSHINE ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.