Provider Demographics
NPI:1124717715
Name:INNERLIGHT COMMUNITY ADVOCATES PLLC
Entity type:Organization
Organization Name:INNERLIGHT COMMUNITY ADVOCATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:AMADOR
Authorized Official - Suffix:
Authorized Official - Credentials:QMHP-CS
Authorized Official - Phone:832-840-5685
Mailing Address - Street 1:2000 CRAWFORD ST STE 869
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-2244
Mailing Address - Country:US
Mailing Address - Phone:832-387-4368
Mailing Address - Fax:
Practice Address - Street 1:2000 CRAWFORD ST STE 869
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-2244
Practice Address - Country:US
Practice Address - Phone:832-387-4368
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-01
Last Update Date:2024-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase Management
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty