Provider Demographics
NPI:1407623457
Name:WELLNESS INNERBALANCE THERAPY PLLC
Entity Type:Organization
Organization Name:WELLNESS INNERBALANCE THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HABIBATU
Authorized Official - Middle Name:OLABIMPE
Authorized Official - Last Name:BADMUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-490-4636
Mailing Address - Street 1:5303 S MASON RD APT 2326
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-7179
Mailing Address - Country:US
Mailing Address - Phone:832-490-4636
Mailing Address - Fax:
Practice Address - Street 1:18919 FULVETTA HAVEN WAY
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-2378
Practice Address - Country:US
Practice Address - Phone:832-490-4636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty