| Bridging The Gap Psychological Services, Llc | |
|
633 East Ferhurst Drive Suite 301 Katy TX 77450 | |
| (832) 900-9819 | |
| Not Available |
| Full Name | Bridging The Gap Psychological Services, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 633 East Ferhurst Drive Suite 301, Katy, Texas |
| Authorized Official Name and Position | Dr. Tioana Maxwell (LICENSED CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 8325820556 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bridging The Gap Psychological Services, Llc 633 East Ferhurst Drive Suite 301 Katy TX 77450 Ph: (832) 582-0556 | Bridging The Gap Psychological Services, Llc 633 East Ferhurst Drive Suite 301 Katy TX 77450 Ph: (832) 900-9819 |
| NPI Number | 1235826058 |
|---|---|
| Provider Enumeration Date | 04/20/2023 |
| Last Update Date | 07/01/2024 |
| Certification Date | 06/24/2024 |
| Medicare PECOS PAC ID | 7911359039 |
|---|---|
| Medicare Enrollment ID | O20240113000639 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235826058 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Tioana M Maxwell |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356574743 PECOS PAC ID: 3678616612 Enrollment ID: I20131230000910 |
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