Provider Demographics
NPI:1841943297
Name:INTENTIONAL THERAPY, PLLC
Entity type:Organization
Organization Name:INTENTIONAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSED PROFESSIONAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:PARTHI
Authorized Official - Middle Name:BAKUL
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:210-816-1488
Mailing Address - Street 1:3100 DISCOVERY DR
Mailing Address - Street 2:
Mailing Address - City:OAK POINT
Mailing Address - State:TX
Mailing Address - Zip Code:75068-1687
Mailing Address - Country:US
Mailing Address - Phone:210-816-1488
Mailing Address - Fax:
Practice Address - Street 1:1131 QUEENSDOWN WAY
Practice Address - Street 2:
Practice Address - City:FORNEY
Practice Address - State:TX
Practice Address - Zip Code:75126-3579
Practice Address - Country:US
Practice Address - Phone:214-506-8094
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-26
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty