Provider Demographics
NPI:1760138028
Name:NEUROFEEDBACK OF CYPRESS, LLC
Entity Type:Organization
Organization Name:NEUROFEEDBACK OF CYPRESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DAWN-PETRICE
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNGS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:281-315-0386
Mailing Address - Street 1:25472 KIMBRO RD
Mailing Address - Street 2:
Mailing Address - City:HOCKLEY
Mailing Address - State:TX
Mailing Address - Zip Code:77447
Mailing Address - Country:US
Mailing Address - Phone:281-315-0386
Mailing Address - Fax:832-653-6379
Practice Address - Street 1:16712 HUFFMEISTER RD
Practice Address - Street 2:BLDG 200C
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429
Practice Address - Country:US
Practice Address - Phone:281-315-0386
Practice Address - Fax:832-653-6379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-25
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty