Provider Demographics
NPI:1467200162
Name:HOUSTON ANXIETY AND WELLNESS CENTER
Entity type:Organization
Organization Name:HOUSTON ANXIETY AND WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:IVY
Authorized Official - Middle Name:
Authorized Official - Last Name:RUTHS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:832-444-4749
Mailing Address - Street 1:823 KAMANO AVE
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-3293
Mailing Address - Country:US
Mailing Address - Phone:832-444-4749
Mailing Address - Fax:
Practice Address - Street 1:4306 YOAKUM BLVD STE 510
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-5884
Practice Address - Country:US
Practice Address - Phone:832-444-4749
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty