Provider Demographics
NPI:1790581866
Name:THE VILLAGE BUILDERS CLINICAL COUNSELING SOLUTIONS AND CONSULTING, PLL
Entity type:Organization
Organization Name:THE VILLAGE BUILDERS CLINICAL COUNSELING SOLUTIONS AND CONSULTING, PLL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:L
Authorized Official - Last Name:TANNER
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, LPC, LMFT, LADC
Authorized Official - Phone:580-512-9862
Mailing Address - Street 1:PO BOX 40
Mailing Address - Street 2:
Mailing Address - City:FULSHEAR
Mailing Address - State:TX
Mailing Address - Zip Code:77441-0040
Mailing Address - Country:US
Mailing Address - Phone:580-512-9862
Mailing Address - Fax:
Practice Address - Street 1:2717 COMMERCIAL CENTER BLVD STE E200
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-7823
Practice Address - Country:US
Practice Address - Phone:346-436-7334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)