Provider Demographics
NPI:1073919056
Name:GENETTE STANTON THERAPY, LLC
Entity Type:Organization
Organization Name:GENETTE STANTON THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:GENETTE
Authorized Official - Middle Name:DODSON
Authorized Official - Last Name:STANTON
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LPC, NCC
Authorized Official - Phone:713-819-8663
Mailing Address - Street 1:2219 SAWDUST RD
Mailing Address - Street 2:SUITE 1101
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-2575
Mailing Address - Country:US
Mailing Address - Phone:713-819-8663
Mailing Address - Fax:832-442-5707
Practice Address - Street 1:2219 SAWDUST RD
Practice Address - Street 2:SUITE 1101
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-2575
Practice Address - Country:US
Practice Address - Phone:713-819-8663
Practice Address - Fax:832-442-5707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-18
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65859101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty