Provider Demographics
NPI:1144897497
Name:AMPLIFY PLUS THERAPY & COACHING PLLC
Entity type:Organization
Organization Name:AMPLIFY PLUS THERAPY & COACHING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:W
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LCSWS
Authorized Official - Phone:346-341-7971
Mailing Address - Street 1:4220 CARTWRIGHT RD STE 105
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-5307
Mailing Address - Country:US
Mailing Address - Phone:346-341-7971
Mailing Address - Fax:
Practice Address - Street 1:2706 LAKE VILLA DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-7650
Practice Address - Country:US
Practice Address - Phone:281-782-1641
Practice Address - Fax:281-969-7259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-07
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX60118OtherTEXAS STATE BOARD OF SOCIAL WORKER EXAMINERS
14238488OtherCAQH