Expansive Light Psychotherapy PLLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

EXPANSIVE LIGHT PSYCHOTHERAPY PLLC

Practice address

2640 E League City Pkwy Ste 104-930
League City, TX 77573-3368

Phone

(240) 328-8865

NPI assigned

Feb 13, 2024

Last updated

Feb 13, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tamielle Maree Taylor, MA, LPC, LCPCNPI 1487214771

Title

Managing Member

Phone

(240) 328-8865

Specialties & licenses 1

Addresses

Other names 1

• Expansive Light Psychotherapy LLC Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tamielle Maree Taylor, MA, LPC, LCPC

  • Professional Counselor
  • League City, TX
  • NPI 1487214771
  NPD Authorized official

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

{
    "created_epoch": "1707782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707782400000",
    "number": "1285498865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2640 E LEAGUE CITY PKWY STE 104-930",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775733368",
            "telephone_number": "240-328-8865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 E LEAGUE CITY PKWY STE 104-930",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775733368",
            "telephone_number": "240-328-8865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPANSIVE LIGHT PSYCHOTHERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-13",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "TAMIELLE",
        "authorized_official_middle_name": "MAREE",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "240-328-8865",
        "authorized_official_credential": "MA, LPC, LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Expansive Light Psychotherapy LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Fe Marie Terese Evangelista, D.C.
• Carlos Rudolph Evering, DO
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• Carol-Lynn Hendrych Faciane, RNFA
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• Mental Health Counselor in League City, TX
• Providers in League City, TX by specialty
• Mental Health Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.