Provider Demographics
NPI:1992721419
Name:ERIN BRYANT-BAINS
Entity type:Organization
Organization Name:ERIN BRYANT-BAINS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRYANT-BAINS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:713-248-1961
Mailing Address - Street 1:PO BOX 440745
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77244-0745
Mailing Address - Country:US
Mailing Address - Phone:713-248-1961
Mailing Address - Fax:
Practice Address - Street 1:12407 BRANDYWYNE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-4815
Practice Address - Country:US
Practice Address - Phone:713-248-1961
Practice Address - Fax:281-920-4366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX146771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8D2169Medicare ID - Type UnspecifiedINDIVIDUAL NUMBER
TX00274YMedicare ID - Type UnspecifiedGROUP NUMBER