Provider Demographics
NPI:1205011855
Name:THE CENTER FOR RELATIONSHIP WELLNESS
Entity type:Organization
Organization Name:THE CENTER FOR RELATIONSHIP WELLNESS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:281-480-0200
Mailing Address - Street 1:1560 W BAY AREA BLVD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-2667
Mailing Address - Country:US
Mailing Address - Phone:281-480-0200
Mailing Address - Fax:281-480-0202
Practice Address - Street 1:1560 W BAY AREA BLVD
Practice Address - Street 2:SUITE 310
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-2667
Practice Address - Country:US
Practice Address - Phone:281-480-0200
Practice Address - Fax:281-480-0202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-02
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11023101YP2500X
TX2919106H00000X
TX13397101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0044NNOtherBLUE CROSS BLUE SHIELD