Provider Demographics
NPI:1003680521
Name:PSYCHEASE THERAPY LLC
Entity Type:Organization
Organization Name:PSYCHEASE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON-MADUEKE
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:707-720-9289
Mailing Address - Street 1:9801 WESTHEIMER RD STE 300
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-3979
Mailing Address - Country:US
Mailing Address - Phone:707-720-9289
Mailing Address - Fax:707-203-8184
Practice Address - Street 1:9801 WESTHEIMER RD STE 300
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-3979
Practice Address - Country:US
Practice Address - Phone:707-720-9289
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-14
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty