Provider Demographics
NPI:1902389935
Name:THE MENTAL WELLNESS AND BEHAVIORAL HEALTH CENTER, PLLC
Entity Type:Organization
Organization Name:THE MENTAL WELLNESS AND BEHAVIORAL HEALTH CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:346-242-6663
Mailing Address - Street 1:5300 N BRAESWOOD BLVD STE 4-626
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-3307
Mailing Address - Country:US
Mailing Address - Phone:346-242-6663
Mailing Address - Fax:713-729-1203
Practice Address - Street 1:52 SUGAR CREEK CENTER BLVD STE 225
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-2209
Practice Address - Country:US
Practice Address - Phone:346-242-6663
Practice Address - Fax:713-729-1203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-14
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3540478-01Medicaid