Provider Demographics
NPI:1710653522
Name:BISSETT PSYCHOLOGICAL SERVICES, PLLC
Entity Type:Organization
Organization Name:BISSETT PSYCHOLOGICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:L
Authorized Official - Last Name:BISSETT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:713-412-8299
Mailing Address - Street 1:216 N MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-2431
Mailing Address - Country:US
Mailing Address - Phone:713-412-8299
Mailing Address - Fax:
Practice Address - Street 1:216 N MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-2431
Practice Address - Country:US
Practice Address - Phone:713-412-8299
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-20
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty