| Tangled Wellness Llc | |
|
1775 Saint James Pl Ste 325 Houston TX 77056-3416 | |
| (832) 266-7007 | |
| Not Available |
| Full Name | Tangled Wellness Llc |
|---|---|
| Speciality | Counselor |
| Location | 1775 Saint James Pl Ste 325, Houston, Texas |
| Authorized Official Name and Position | Dustin Zeigenbein (OWNER) |
| Authorized Official Contact | 2819087101 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tangled Wellness Llc 1775 Saint James Pl Ste 325 Houston TX 77056-3416 Ph: (832) 266-7007 | Tangled Wellness Llc 1775 Saint James Pl Ste 325 Houston TX 77056-3416 Ph: (832) 266-7007 |
| NPI Number | 1124756846 |
|---|---|
| Provider Enumeration Date | 08/10/2022 |
| Last Update Date | 12/27/2023 |
| Certification Date | 12/27/2023 |
| Medicare PECOS PAC ID | 2062863277 |
|---|---|
| Medicare Enrollment ID | O20240111002116 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124756846 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Lynsay Erin Gaines |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619491701 PECOS PAC ID: 1052659034 Enrollment ID: I20190218001281 |
| Provider Name | Sable Mcelveen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912659491 PECOS PAC ID: 9335534841 Enrollment ID: I20220321001011 |
| Provider Name | Shanica Jones-colson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235533712 PECOS PAC ID: 5092157792 Enrollment ID: I20240528000401 |
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