Provider Demographics
NPI:1427822154
Name:RELATE PSYCHOLOGICAL SERVICES
Entity type:Organization
Organization Name:RELATE PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TENNILLE
Authorized Official - Middle Name:
Authorized Official - Last Name:WARREN-PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:832-736-4469
Mailing Address - Street 1:11601 SHADOW CREEK PKWY
Mailing Address - Street 2:SUITE 111, #694
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584
Mailing Address - Country:US
Mailing Address - Phone:832-736-4469
Mailing Address - Fax:
Practice Address - Street 1:431 NURSERY RD STE C800
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-1993
Practice Address - Country:US
Practice Address - Phone:832-736-4469
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty