Provider Demographics
NPI:1740752476
Name:REAL TALK LLC
Entity Type:Organization
Organization Name:REAL TALK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ADRIANE
Authorized Official - Middle Name:DE FREITAS
Authorized Official - Last Name:BARROSO
Authorized Official - Suffix:
Authorized Official - Credentials:LP
Authorized Official - Phone:832-583-7373
Mailing Address - Street 1:7670 WOODWAY DR STE 270
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-1598
Mailing Address - Country:US
Mailing Address - Phone:832-583-7373
Mailing Address - Fax:832-583-7272
Practice Address - Street 1:7670 WOODWAY DR STE 270
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-1598
Practice Address - Country:US
Practice Address - Phone:832-583-7373
Practice Address - Fax:832-583-7272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-19
Last Update Date:2022-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1134696826OtherNPI