Provider Demographics
NPI:1801204367
Name:CHOICES TO CHANGES PSYCHOTHERAPY
Entity Type:Organization
Organization Name:CHOICES TO CHANGES PSYCHOTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LERLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTOYO
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, ASOTP
Authorized Official - Phone:832-754-9925
Mailing Address - Street 1:2616 S LOOP W
Mailing Address - Street 2:SUITE 550
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2662
Mailing Address - Country:US
Mailing Address - Phone:832-754-9925
Mailing Address - Fax:713-283-0821
Practice Address - Street 1:2616 S LOOP W
Practice Address - Street 2:SUITE 550
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2662
Practice Address - Country:US
Practice Address - Phone:832-754-9925
Practice Address - Fax:713-283-0821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-29
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63927261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX208272903Medicaid