Provider Demographics
NPI:1184032633
Name:LIVINGWELL PSYCHOTHERAPY, INC.
Entity Type:Organization
Organization Name:LIVINGWELL PSYCHOTHERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:ESTEP
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:281-731-3108
Mailing Address - Street 1:PO BOX 1587
Mailing Address - Street 2:
Mailing Address - City:CROSBY
Mailing Address - State:TX
Mailing Address - Zip Code:77532-1587
Mailing Address - Country:US
Mailing Address - Phone:281-731-3108
Mailing Address - Fax:281-457-1014
Practice Address - Street 1:8530 FM 1960 RD E STE 110
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-1831
Practice Address - Country:US
Practice Address - Phone:281-731-3108
Practice Address - Fax:281-457-1014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-29
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65682101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty