Provider Demographics
NPI:1962980623
Name:SUNBEAM PSYCHOTHERAPY AND WELLNESS CONSULTANTS LLC
Entity type:Organization
Organization Name:SUNBEAM PSYCHOTHERAPY AND WELLNESS CONSULTANTS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER AND CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:GRINSFELDER
Authorized Official - Last Name:WILKES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:713-444-2756
Mailing Address - Street 1:1810 SEA QUEEN CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-1233
Mailing Address - Country:US
Mailing Address - Phone:713-444-2756
Mailing Address - Fax:
Practice Address - Street 1:2190 NORTH LOOP W STE 402
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018-8129
Practice Address - Country:US
Practice Address - Phone:713-444-2756
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-03
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX53434261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center