Organization Active NPI

Mental Wellness Services, PC

  • Psychologist
  • Houston, TX
National Provider Identifier
1053514463
Registry record updated Nov 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
31916 Issued in TX
Legal business name
MENTAL WELLNESS SERVICES, PC
Practice address
505 N Sam Houston Pkwy E
Suite 502
Houston, TX 77060-4018
Phone
(281) 447-9355
Fax
(281) 447-9356
NPI assigned
Jun 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Rosell L. Jenkins, PH.D.NPI 1558307736
Title
President
Phone
(281) 447-9355

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 31916 TX Primary

Addresses

Primary practice location

505 N Sam Houston Pkwy E
Suite 502
Houston, TX 77060-4018

Mailing address

505 N Sam Houston Pkwy E
Suite 502
Houston, TX 77060-4018
Phone (281) 447-9355

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080424000715 TX Part B Supplier - Clinic/Group Practice 1557449907 Receives reassigned benefits from 1 practitioner
Practice locations: Humble, TX

National Provider Directory

National Provider Directory

Locations

9659 N Sam Houston Pkwy E
Ste 150
Humble, TX 77396
Phone (281) 979-6671

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196380800000",
    "number": "1053514463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 N SAM HOUSTON PKWY E",
            "address_2": "SUITE 502",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770604018",
            "telephone_number": "281-447-9355",
            "fax_number": "281-447-9356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 N SAM HOUSTON PKWY E",
            "address_2": "SUITE 502",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770604018",
            "telephone_number": "281-447-9355",
            "fax_number": "281-447-9356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL WELLNESS SERVICES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-06",
        "last_updated": "2007-11-30",
        "status": "A",
        "authorized_official_last_name": "JENKINS",
        "authorized_official_first_name": "ROSELL",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "281-447-9355",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "TX",
            "license": "31916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.