Provider Demographics
NPI:1144556051
Name:STORY HEALTHCARE ENTERPRISES, LLC
Entity type:Organization
Organization Name:STORY HEALTHCARE ENTERPRISES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:STORY
Authorized Official - Suffix:I
Authorized Official - Credentials:LMSW, LMFT
Authorized Official - Phone:832-585-9945
Mailing Address - Street 1:25310 PINEY BEND CT
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77389-3583
Mailing Address - Country:US
Mailing Address - Phone:832-585-9945
Mailing Address - Fax:888-206-9979
Practice Address - Street 1:1103 ANDERSON ST
Practice Address - Street 2:SUITE 102
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77840-4494
Practice Address - Country:US
Practice Address - Phone:832-585-9945
Practice Address - Fax:888-206-9979
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STORY HEALTHCARE ENTERPRISES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-10-27
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX135671041C0700X
TX4347106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty