Provider Demographics
NPI:1487236238
Name:MARISOL MENDEZ THERAPY, PLLC
Entity type:Organization
Organization Name:MARISOL MENDEZ THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MARISOL
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:832-597-1111
Mailing Address - Street 1:5206 SAGE CIR
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-8253
Mailing Address - Country:US
Mailing Address - Phone:832-597-1111
Mailing Address - Fax:
Practice Address - Street 1:5206 SAGE CIR
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-8253
Practice Address - Country:US
Practice Address - Phone:832-597-1111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-22
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty