| Therapeutic Alliance Llc | |
|
7807 Long Point Rd Suite 440 Houston TX 77055-3679 | |
| (800) 419-2568 | |
| (832) 900-9518 |
| Full Name | Therapeutic Alliance Llc |
|---|---|
| Speciality | Counselor |
| Location | 7807 Long Point Rd, Houston, Texas |
| Authorized Official Name and Position | Henry Martez Pittman (OWNER) |
| Authorized Official Contact | 8004192568 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Therapeutic Alliance Llc 7807 Long Point Rd Suite 440 Houston TX 77055-3679 Ph: (800) 419-2568 | Therapeutic Alliance Llc 7807 Long Point Rd Suite 440 Houston TX 77055-3679 Ph: (800) 419-2568 |
| NPI Number | 1457734352 |
|---|---|
| Provider Enumeration Date | 07/09/2015 |
| Last Update Date | 07/09/2015 |
| Medicare PECOS PAC ID | 0244775898 |
|---|---|
| Medicare Enrollment ID | O20240709000037 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457734352 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 9583 (Texas) | Secondary |
| 101YP2500X | Counselor - Professional | 67531 (Texas) | Primary |
| Provider Name | Henry Martez Pittman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285889634 PECOS PAC ID: 1153866702 Enrollment ID: I20240709000080 |
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