Provider Demographics
NPI:1811236011
Name:REHABILITATION PSYCHOLOGY MANAGEMENT PLLC
Entity type:Organization
Organization Name:REHABILITATION PSYCHOLOGY MANAGEMENT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STUART
Authorized Official - Middle Name:J
Authorized Official - Last Name:NATHAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:713-789-7560
Mailing Address - Street 1:2450 FONDREN RD
Mailing Address - Street 2:SUITE 312
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-2318
Mailing Address - Country:US
Mailing Address - Phone:713-789-7560
Mailing Address - Fax:713-789-7351
Practice Address - Street 1:2450 FONDREN RD
Practice Address - Street 2:SUITE 312
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-2318
Practice Address - Country:US
Practice Address - Phone:713-789-7560
Practice Address - Fax:713-789-7351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-07
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23367101Y00000X, 101YM0800X, 101YP2500X, 103T00000X, 103TB0200X, 103TC1900X, 103TR0400X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitationGroup - Single Specialty