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BRAZOS VALLEY MENTAL HEALTH AND WELLNESS LLC NPI 1063874683


NPI Information

NPI: 1063874683
Provider Name: BRAZOS VALLEY MENTAL HEALTH AND WELLNESS, LLC
Classification: Psychologist - 103TC0700X
Entity Type: Organization

Specialization: Clinical

CLIA Number: 45D0498423

Address:
2554 E VILLA MARIA RD
BRYAN, TX
ZIP 77802
Phone: (979) 777-1683
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BRAZOS VALLEY MENTAL HEALTH AND WELLNESS, LLC is a clinical psychologist in Bryan, TX. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. BRAZOS VALLEY MENTAL HEALTH AND WELLNESS, LLC NPI is 1063874683. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2554 E VILLA MARIA RD
BRYAN, TX
ZIP 77802-037
Phone: (979) 777-1683

The provider's authorized official is Sherry Haferkamp .
The authorized official title is Clinical Psychologist and has the following contact phone number (979) 777-1683.

The CLIA number assigned to this NPI record is 45D0498423 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 3/23/2016 and was last updated on 7/22/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103TC0700XPsychologistClinical37193TEXASYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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