Provider Demographics
NPI:1720650351
Name:URBAN WELLNESS ASSOCIATES, LLC
Entity Type:Organization
Organization Name:URBAN WELLNESS ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BRITTNEY
Authorized Official - Middle Name:N
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S
Authorized Official - Phone:832-862-5950
Mailing Address - Street 1:25807 WESTHEIMER PKWY STE 326
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-5333
Mailing Address - Country:US
Mailing Address - Phone:832-862-5950
Mailing Address - Fax:346-396-3590
Practice Address - Street 1:25807 WESTHEIMER PKWY STE 302
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-5342
Practice Address - Country:US
Practice Address - Phone:832-862-5950
Practice Address - Fax:346-396-3590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-13
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No251B00000XAgenciesCase Management
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX396202901Medicaid