Provider Demographics
NPI:1992946990
Name:BANYAN COUNSELING NETWORK, L.L.C.
Entity type:Organization
Organization Name:BANYAN COUNSELING NETWORK, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAVODNY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC-S, LMFT
Authorized Official - Phone:281-855-1982
Mailing Address - Street 1:5870 HIGHWAY 6 N
Mailing Address - Street 2:SUITE 107
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-1802
Mailing Address - Country:US
Mailing Address - Phone:281-855-1982
Mailing Address - Fax:832-786-3675
Practice Address - Street 1:5870 HIGHWAY 6 N
Practice Address - Street 2:SUITE 107
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-1802
Practice Address - Country:US
Practice Address - Phone:281-855-1982
Practice Address - Fax:832-786-3675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-20
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201315106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty