Provider Demographics
NPI:1396585436
Name:TOMMIE D. BURRELL, LCSW COUNSELING PLLC
Entity type:Organization
Organization Name:TOMMIE D. BURRELL, LCSW COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TOMMIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:BURRELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:832-316-1182
Mailing Address - Street 1:3363 MCCUE RD APT 220
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-6768
Mailing Address - Country:US
Mailing Address - Phone:832-316-1182
Mailing Address - Fax:
Practice Address - Street 1:2100 TRAVIS ST STE 1510
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-8783
Practice Address - Country:US
Practice Address - Phone:832-316-1182
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)