Provider Demographics
NPI:1154997450
Name:LIVE OAK THERAPY GROUP PLLC
Entity type:Organization
Organization Name:LIVE OAK THERAPY GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BOU KHEIR
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:832-368-5983
Mailing Address - Street 1:26311 WESTHEIMER PKWY
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-5368
Mailing Address - Country:US
Mailing Address - Phone:832-368-5983
Mailing Address - Fax:
Practice Address - Street 1:26311 WESTHEIMER PKWY
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-5368
Practice Address - Country:US
Practice Address - Phone:832-368-5983
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-28
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty