Provider Demographics
NPI:1518367218
Name:PSYCHOTHERAPY PARTNERS
Entity Type:Organization
Organization Name:PSYCHOTHERAPY PARTNERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEUROPSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAWANDA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WILLIAMS-ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:PH D
Authorized Official - Phone:281-436-7292
Mailing Address - Street 1:11811 NORTH FWY # I-45S
Mailing Address - Street 2:SUITE 547
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77060-3245
Mailing Address - Country:US
Mailing Address - Phone:281-436-7292
Mailing Address - Fax:844-436-7291
Practice Address - Street 1:11811 NORTH FWY # I-45S
Practice Address - Street 2:SUITE 547
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-3245
Practice Address - Country:US
Practice Address - Phone:281-436-7292
Practice Address - Fax:844-436-7291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-29
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33380103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX343061301Medicaid
TX376364Medicare UPIN