St. Mary'S Place, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

ST. MARY'S PLACE, LLC

Practice address

3707 Cypress Creek Pkwy
Houston, TX 77068-3526

Phone

(832) 894-9359

NPI assigned

Nov 9, 2023

Organization subpart

No

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

Authorized official

Name

Kimberly Celeste Bass, MA, LPC, LCDC, LSOTPNPI 1790981561

Title

Ceo

Phone

(832) 894-9359

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 2

• The Psych Pro Doing business as
• VOCATIONAL LIVING CENTER Former legal business name

Practitioners 1

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

• Kimberly Bass, LPC

  • Professional Counselor
  • Houston, TX
  • NPI 1790981561
  NPD Authorized official

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

{
    "created_epoch": "1699488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699488000000",
    "number": "1275307266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1838",
            "city": "ALIEF",
            "state": "TX",
            "postal_code": "774111838",
            "telephone_number": "832-894-9359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3707 CYPRESS CREEK PKWY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770683526",
            "telephone_number": "832-894-9359"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5680 King Centre Dr",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223155757",
            "country_code": "US",
            "telephone_number": "832-894-9359",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Concho St",
            "address_purpose": "LOCATION",
            "city": "San Marcos",
            "state": "TX",
            "postal_code": "786665701",
            "country_code": "US",
            "telephone_number": "832-894-9359",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ST. MARY'S PLACE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-09",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A",
        "authorized_official_last_name": "BASS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "CELESTE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "832-894-9359",
        "authorized_official_credential": "MA, LPC, LCDC, LSOTP"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4173981-02",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4173981-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Psych Pro",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "VOCATIONAL LIVING CENTER",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Professional Counselor in Houston, TX
• Providers in Houston, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; 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.