Provider Demographics
NPI:1386483014
Name:HALEIGH CULVERHOUSE
Entity type:Organization
Organization Name:HALEIGH CULVERHOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:HALEIGH
Authorized Official - Middle Name:
Authorized Official - Last Name:CULVERHOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:832-685-8573
Mailing Address - Street 1:115 N DIXIE DR STE 120
Mailing Address - Street 2:
Mailing Address - City:LAKE JACKSON
Mailing Address - State:TX
Mailing Address - Zip Code:77566-5958
Mailing Address - Country:US
Mailing Address - Phone:832-685-8573
Mailing Address - Fax:
Practice Address - Street 1:115 N DIXIE DR STE 120
Practice Address - Street 2:
Practice Address - City:LAKE JACKSON
Practice Address - State:TX
Practice Address - Zip Code:77566-5958
Practice Address - Country:US
Practice Address - Phone:832-685-8573
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty