Provider Demographics
NPI:1659762706
Name:ESSENCE PSYCHOLOGICAL HEALTH SERVICES
Entity Type:Organization
Organization Name:ESSENCE PSYCHOLOGICAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JASMINE
Authorized Official - Middle Name:ROSS
Authorized Official - Last Name:BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:713-492-2260
Mailing Address - Street 1:6300 WEST LOOP S STE 410
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-2902
Mailing Address - Country:US
Mailing Address - Phone:713-492-2260
Mailing Address - Fax:713-492-2173
Practice Address - Street 1:900 LOVETT BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-3908
Practice Address - Country:US
Practice Address - Phone:832-792-2533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-11
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36727103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty