Provider Demographics
NPI:1841448594
Name:FAMILY PSYCHSOLUTIONS
Entity type:Organization
Organization Name:FAMILY PSYCHSOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIELA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:COSTA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:281-902-1050
Mailing Address - Street 1:9307 BROADWAY ST
Mailing Address - Street 2:SUITE 323
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-9765
Mailing Address - Country:US
Mailing Address - Phone:281-092-1050
Mailing Address - Fax:281-902-1051
Practice Address - Street 1:9307 BROADWAY ST
Practice Address - Street 2:SUITE 323
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-9765
Practice Address - Country:US
Practice Address - Phone:281-092-1050
Practice Address - Fax:281-902-1051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-07
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
TX33763103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2006272Medicaid