Provider Demographics
NPI:1578707220
Name:CHARIS PSYCHOLOGICAL ASSOCIATES
Entity Type:Organization
Organization Name:CHARIS PSYCHOLOGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAULINE
Authorized Official - Middle Name:AMOS
Authorized Official - Last Name:CLANSY
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:713-777-8633
Mailing Address - Street 1:8303 SOUTHWEST FWY
Mailing Address - Street 2:STE 640
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1601
Mailing Address - Country:US
Mailing Address - Phone:713-777-8633
Mailing Address - Fax:713-777-5259
Practice Address - Street 1:8303 SOUTHWEST FWY
Practice Address - Street 2:STE 640
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1601
Practice Address - Country:US
Practice Address - Phone:713-777-8633
Practice Address - Fax:713-777-5259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-25
Last Update Date:2009-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2-3329103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty