Peace Pavilion Mental Healthcare and Counseling Services PLLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

PEACE PAVILION MENTAL HEALTHCARE AND COUNSELING SERVICES PLLC

Practice address

9950 Westpark Dr Ste 528
Houston, TX 77063-5274

Phone

(630) 504-8745

NPI assigned

Dec 18, 2023

Organization subpart

No

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

Authorized official

Name

Bolanle Awotiku, NPNPI 1588148365

Title

Pmhnp

Phone

(630) 504-8745

Specialties & licenses 1

Addresses

Other names 1

• PEACE PAVILION MENTAL HEALTHCARE AND COUNSELING SERVICES PLLC Former legal business name

Locations

Practitioners 1

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

• Bolanle Awotiku, NP

  • Registered Nurse
  • Richmond, TX
  • NPI 1588148365

  Psychiatric/Mental Health

  NPD Authorized official

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

{
    "created_epoch": "1702857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704240000000",
    "number": "1104694389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11747 GIOVANNI LN",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774061536",
            "telephone_number": "630-504-8745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9950 WESTPARK DR STE 528",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770635274",
            "telephone_number": "630-504-8745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACE PAVILION MENTAL HEALTHCARE AND COUNSELING SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-18",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A",
        "authorized_official_last_name": "AWOTIKU",
        "authorized_official_first_name": "BOLANLE",
        "authorized_official_title_or_position": "PMHNP",
        "authorized_official_telephone_number": "630-504-8745",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PEACE PAVILION MENTAL HEALTHCARE AND COUNSELING SERVICES PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Psychiatric/Mental Health Nurse Practitioner in Houston, TX
• Providers in Houston, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.