Provider Demographics
NPI:1710608823
Name:TRAUMA AND GRIEF SUPPORT SERVICES, PLLC
Entity Type:Organization
Organization Name:TRAUMA AND GRIEF SUPPORT SERVICES, PLLC
Other - Org Name:LUCINE CENTER FOR TRAUMA AND GRIEF
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KAPLOW
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, ABPP
Authorized Official - Phone:734-355-9227
Mailing Address - Street 1:6711 STELLA LINK RD # 466
Mailing Address - Street 2:
Mailing Address - City:WEST UNIVERSITY PLACE
Mailing Address - State:TX
Mailing Address - Zip Code:77005-4342
Mailing Address - Country:US
Mailing Address - Phone:832-244-9502
Mailing Address - Fax:832-356-2743
Practice Address - Street 1:2900 NORTH LOOP WEST
Practice Address - Street 2:STE 500
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092
Practice Address - Country:US
Practice Address - Phone:832-244-9502
Practice Address - Fax:832-356-2743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-07
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No251S00000XAgenciesCommunity/Behavioral Health