Provider Demographics
NPI:1639743610
Name:MOORE GUDERIAN MINDFUL SOLUTIONS
Entity Type:Organization
Organization Name:MOORE GUDERIAN MINDFUL SOLUTIONS
Other - Org Name:THINK CHANGE COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MSW, LCSW/OWNER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:JUSTINE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-262-2230
Mailing Address - Street 1:2314 RAFFAELLO DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-1608
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1350 NASA ROAD 1
Practice Address - Street 2:SUITE 112
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058
Practice Address - Country:US
Practice Address - Phone:281-262-2230
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-14
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty