Provider Demographics
NPI:1679232243
Name:SAPERE AUDE PSYCHOTHERAPY, PLLC
Entity Type:Organization
Organization Name:SAPERE AUDE PSYCHOTHERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:409-960-1727
Mailing Address - Street 1:5300 N BRAESWOOD BLVD STE 4-V665
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-3307
Mailing Address - Country:US
Mailing Address - Phone:832-315-4545
Mailing Address - Fax:
Practice Address - Street 1:5300 N BRAESWOOD BLVD STE 4-V665
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096-3307
Practice Address - Country:US
Practice Address - Phone:832-315-4545
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-10
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1962067421OtherNPI