Provider Demographics
NPI:1366064073
Name:ROLLIE B. ELIZONDO PSYCHOTHERAPY & COUNSELING PLLC
Entity type:Organization
Organization Name:ROLLIE B. ELIZONDO PSYCHOTHERAPY & COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ROLLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ELIZONDO
Authorized Official - Suffix:JR
Authorized Official - Credentials:LCSW
Authorized Official - Phone:713-364-6755
Mailing Address - Street 1:310 SUL ROSS ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-5116
Mailing Address - Country:US
Mailing Address - Phone:713-364-6755
Mailing Address - Fax:
Practice Address - Street 1:310 SUL ROSS ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-5116
Practice Address - Country:US
Practice Address - Phone:713-494-0502
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-15
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health