Provider Demographics
NPI:1255152369
Name:CASTING CROWN PSYCHIATRY SERVICES PLLC
Entity type:Organization
Organization Name:CASTING CROWN PSYCHIATRY SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DADAKPOYE
Authorized Official - Middle Name:TINA
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:936-235-0001
Mailing Address - Street 1:4606 FM 1960 RD W STE 430
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77069-1038
Mailing Address - Country:US
Mailing Address - Phone:713-766-2978
Mailing Address - Fax:
Practice Address - Street 1:4606 FM 1960 RD W STE 430
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069-1038
Practice Address - Country:US
Practice Address - Phone:713-766-2970
Practice Address - Fax:713-766-2970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-21
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty