Provider Demographics
NPI:1710318605
Name:PATEL COUNSELING AND MEDIATION SERVICES, PLLC
Entity Type:Organization
Organization Name:PATEL COUNSELING AND MEDIATION SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:TANVI
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S
Authorized Official - Phone:713-568-5764
Mailing Address - Street 1:14029 NORTHWEST FWY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77040-5117
Mailing Address - Country:US
Mailing Address - Phone:713-568-5764
Mailing Address - Fax:
Practice Address - Street 1:2217 PARK AVE
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-4216
Practice Address - Country:US
Practice Address - Phone:281-997-8400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-03
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64129101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty