Organization Active NPI

Total Wellness Assessment & Counseling Center PLLC

  • Clinical Psychologist
  • Houston, TX
National Provider Identifier
1619238003
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
TOTAL WELLNESS ASSESSMENT & COUNSELING CENTER PLLC
Practice address
3801 Kirby Dr Ste 311
Houston, TX 77098-4159
Phone
(281) 907-8089
Fax
(844) 270-8089
NPI assigned
Jun 3, 2012
Last updated
Oct 31, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Authorized official

Name
Dr. Gina Evans, PHDNPI 1710270574
Title
Ceo
Phone
(281) 907-8191

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103G00000X
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

3801 Kirby Dr Ste 311
Houston, TX 77098-4159

Mailing address

3801 Kirby Dr Ste 311
Houston, TX 77098-4159
Phone (281) 907-8191

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190926002060 TX Part B Supplier - Clinic/Group Practice 1759509003 Receives reassigned benefits from 1 practitioner
Practice locations: Houston, TX; Humble, TX

National Provider Directory

National Provider Directory

Locations

3801 Kirby Dr
Ste 311
Houston, TX 77098
Phone (281) 907-8089

8820 Will Clayton Pkwy
Ste A
Humble, TX 77338
Phone (281) 907-8191

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1338681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698710400000",
    "number": "1619238003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 KIRBY DR STE 311",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770984159",
            "telephone_number": "281-907-8191",
            "fax_number": "844-270-8089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 KIRBY DR STE 311",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770984159",
            "telephone_number": "281-907-8089",
            "fax_number": "844-270-8089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL WELLNESS ASSESSMENT & COUNSELING CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-03",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "281-907-8191",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; 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.