Provider Demographics
NPI:1841698628
Name:MELISSA Y. CARPENTIER, PLLC
Entity type:Organization
Organization Name:MELISSA Y. CARPENTIER, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:CARPENTIER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:832-520-1536
Mailing Address - Street 1:4501 CARTWRIGHT RD
Mailing Address - Street 2:STE 103
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-3534
Mailing Address - Country:US
Mailing Address - Phone:832-520-1536
Mailing Address - Fax:866-503-8098
Practice Address - Street 1:4501 CARTWRIGHT RD
Practice Address - Street 2:STE 103
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-3534
Practice Address - Country:US
Practice Address - Phone:832-520-1536
Practice Address - Fax:866-503-8098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-10
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35056103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty