Provider Demographics
NPI:1588400238
Name:UP MENTAL HEALTH
Entity type:Organization
Organization Name:UP MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:R
Authorized Official - Last Name:LEON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S
Authorized Official - Phone:512-406-1484
Mailing Address - Street 1:24230 KUYKENDAHL ROAD
Mailing Address - Street 2:STE 310, #152
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375
Mailing Address - Country:US
Mailing Address - Phone:512-406-1484
Mailing Address - Fax:
Practice Address - Street 1:25207 COLLINGTREE DRIVE
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77389
Practice Address - Country:US
Practice Address - Phone:512-406-1484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)