| Third Space Therapy PLLC | |
|
1942 W Gray St Houston TX 77019-4816 | |
| (408) 857-9016 | |
| Not Available |
| Full Name | Third Space Therapy PLLC |
|---|---|
| Speciality | Counselor |
| Location | 1942 W Gray St, Houston, Texas |
| Authorized Official Name and Position | Belinda Milford (PRESIDENT) |
| Authorized Official Contact | 4088579016 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Third Space Therapy PLLC 1942 W Gray St Houston TX 77019-4816 Ph: (408) 857-9016 | Third Space Therapy PLLC 1942 W Gray St Houston TX 77019-4816 Ph: (408) 857-9016 |
| NPI Number | 1215780234 |
|---|---|
| Provider Enumeration Date | 04/09/2024 |
| Last Update Date | 04/09/2024 |
| Certification Date | 04/09/2024 |
| Medicare PECOS PAC ID | 8729518014 |
|---|---|
| Medicare Enrollment ID | O20250217001726 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215780234 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | () | Primary |
| 261QM0850X | Clinic/center - Adult Mental Health | () | Secondary |
| Provider Name | Kelley R Hendricken |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184725855 PECOS PAC ID: 9739118118 Enrollment ID: I20050805000482 |
| Provider Name | Lynn S Curran |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467686345 PECOS PAC ID: 0648323808 Enrollment ID: I20090805000458 |
| Provider Name | Rebecca Faherty |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699860148 PECOS PAC ID: 5193900298 Enrollment ID: I20110505000583 |
| Provider Name | Jeffrey M Gore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144521055 PECOS PAC ID: 3678717493 Enrollment ID: I20130918000206 |
| Provider Name | Margaret G Fasolo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396048823 PECOS PAC ID: 3072814441 Enrollment ID: I20151209002370 |
| Provider Name | Rosimar Suddeth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922247378 PECOS PAC ID: 3173676194 Enrollment ID: I20210414000782 |
| Provider Name | Shiva Kuczinski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518336338 PECOS PAC ID: 1557708229 Enrollment ID: I20240318003169 |
| Provider Name | Jessica Reed |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1902006901 PECOS PAC ID: 7810430006 Enrollment ID: I20240617000305 |
| Provider Name | Maureen E Lane |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063163970 PECOS PAC ID: 4688101520 Enrollment ID: I20241217002117 |
| Provider Name | Margaret Fitts Falcone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942793328 PECOS PAC ID: 8325568611 Enrollment ID: I20250217001919 |
| Provider Name | Sarah J. Langis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356650279 PECOS PAC ID: 3476071564 Enrollment ID: I20250513000565 |
| Provider Name | Elizabeth Anne Drozdal |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598955767 PECOS PAC ID: 9234657370 Enrollment ID: I20250513002225 |
| Provider Name | Elizabeth Hodlin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669734109 PECOS PAC ID: 8628568607 Enrollment ID: I20251107001891 |
| Provider Name | Tracy-jane E. Pierre |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619643020 PECOS PAC ID: 4385134238 Enrollment ID: I20251107003619 |
| Provider Name | Amanda Louise Jankoli |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942789102 PECOS PAC ID: 3971099458 Enrollment ID: I20260105002663 |
| Provider Name | Jennifer L Griffith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679617070 PECOS PAC ID: 0143709899 Enrollment ID: I20260212001068 |
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