Organization Active NPI

Bridging the Gap Psychological Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Katy, TX
National Provider Identifier
1235826058
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
BRIDGING THE GAP PSYCHOLOGICAL SERVICES, LLC
Practice address
633 East Ferhurst Drive Suite 301
Katy, TX 77450
Phone
(832) 900-9819
NPI assigned
Apr 20, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Authorized official

Name
Dr. Dr. Tioana Maxwell, PSY.D
Title
Licensed Clinical Psychologist
Phone
(832) 582-0556

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

633 East Ferhurst Drive Suite 301
Katy, TX 77450

Mailing address

633 East Ferhurst Drive Suite 301
Katy, TX 77450
Phone (832) 582-0556

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240113000639 TX Part B Supplier - Clinic/Group Practice 7911359039 Receives reassigned benefits from 1 practitioner
Practice locations: Katy, TX

National Provider Directory

National Provider Directory

Locations

633 E Fernhurst Dr
Ste 301
Katy, TX 77450
Phone (832) 900-9819

Practitioners & affiliated clinicians

Practitioners 2

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": "1681948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719792000000",
    "number": "1235826058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 EAST FERHURST DRIVE SUITE 301",
            "city": "KATY",
            "state": "TX",
            "postal_code": "77450",
            "telephone_number": "832-582-0556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 EAST FERHURST DRIVE SUITE 301",
            "city": "KATY",
            "state": "TX",
            "postal_code": "77450",
            "telephone_number": "832-900-9819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGING THE GAP PSYCHOLOGICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-20",
        "last_updated": "2024-07-01",
        "certification_date": "2024-06-24",
        "status": "A",
        "authorized_official_last_name": "MAXWELL",
        "authorized_official_first_name": "DR.",
        "authorized_official_middle_name": "TIOANA",
        "authorized_official_title_or_position": "LICENSED CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "832-582-0556",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; 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.