1770234387 NPI number — TAIWANA M O'NEAL LCSW

Table of content: TAIWANA M O'NEAL LCSW (NPI 1770234387)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770234387 NPI number — TAIWANA M O'NEAL LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
O'NEAL
Provider First Name:
TAIWANA
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
O'NEAL
Provider Other First Name:
TAIWANA
Provider Other Middle Name:
MICHELLE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1770234387
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/15/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11807 WESTHEIMER RD STE 550
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77077-6790
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-222-3884
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11807 WESTHEIMER RD STE 550
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77077-6790
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-617-6544
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/14/2022

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  37628 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 37628 . This is a "TEXAS BEHAVIORAL HEALTH EXECUTIVE COUNCIL" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".