Provider Demographics
NPI:1336891811
Name:THE SECRET PLACE COUNSELING & RESTORATION
Entity Type:Organization
Organization Name:THE SECRET PLACE COUNSELING & RESTORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:SUCHON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:832-524-4620
Mailing Address - Street 1:14090 FM 2920 RD STE G158
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77377-5549
Mailing Address - Country:US
Mailing Address - Phone:832-524-4620
Mailing Address - Fax:
Practice Address - Street 1:14090 FM 2920 RD STE G158
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77377-5549
Practice Address - Country:US
Practice Address - Phone:832-524-4620
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-25
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty