Provider Demographics
NPI:1538601893
Name:KARTIZO THERAPEUTIC COUNSELING SERVICES
Entity type:Organization
Organization Name:KARTIZO THERAPEUTIC COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:ENOCH
Authorized Official - Last Name:INIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-672-9016
Mailing Address - Street 1:5555 LONG PRAIRIE TRCE
Mailing Address - Street 2:1238
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-1759
Mailing Address - Country:US
Mailing Address - Phone:832-672-9016
Mailing Address - Fax:281-901-5657
Practice Address - Street 1:5555 LONG PRAIRIE TRCE
Practice Address - Street 2:1238
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-1759
Practice Address - Country:US
Practice Address - Phone:832-672-9016
Practice Address - Fax:281-901-5657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-17
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty