Organization Active NPI

Individual and Couples Therapy of Texas

  • Adult Mental Health Clinic/Center
  • League City, TX
National Provider Identifier
1306676465
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
INDIVIDUAL AND COUPLES THERAPY OF TEXAS
Practice address
102 E Walker St Ste 102C
League City, TX 77573-3803
Phone
(409) 498-5662
NPI assigned
Aug 5, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Authorized official

Name
Mrs. Jennifer Dittrich Anderson, LMFT, LPCNPI 1386305167
Title
Owner/Therapist
Phone
(713) 578-0474

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
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

102 E Walker St Ste 102C
League City, TX 77573-3803

Mailing address

2706 Carmel Woods Dr
Seabrook, TX 77586-1557
Phone (713) 578-0474

National Provider Directory

National Provider Directory

Locations

102 E Walker St
Ste 102C
League City, TX 77573
Phone (409) 498-5662

Practitioners & affiliated clinicians

Practitioners 1

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": "1722816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722816000000",
    "number": "1306676465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2706 CARMEL WOODS DR",
            "city": "SEABROOK",
            "state": "TX",
            "postal_code": "775861557",
            "telephone_number": "713-578-0474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 E WALKER ST STE 102C",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775733803",
            "telephone_number": "409-498-5662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIVIDUAL AND COUPLES THERAPY OF TEXAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-05",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "DITTRICH",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "713-578-0474",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMFT, LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in League City, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.