Provider Demographics
NPI:1003485210
Name:TELLEZ, LAURA ARACELY (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ARACELY
Last Name:TELLEZ
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13333 DOTSON RD STE 160
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4305
Mailing Address - Country:US
Mailing Address - Phone:346-206-3992
Mailing Address - Fax:832-652-3626
Practice Address - Street 1:12234 SHADOW CREEK PARKWAY, BLDG 10
Practice Address - Street 2:STE 106
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584
Practice Address - Country:US
Practice Address - Phone:346-206-3992
Practice Address - Fax:832-652-3626
Is Sole Proprietor?:No
Enumeration Date:2021-06-22
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX558641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical