Provider Demographics
NPI:1043339039
Name:GATES, JERI ANN (LMSW)
Entity Type:Individual
Prefix:
First Name:JERI
Middle Name:ANN
Last Name:GATES
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4323 WARM SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77035-6023
Mailing Address - Country:US
Mailing Address - Phone:832-978-0146
Mailing Address - Fax:
Practice Address - Street 1:6701 FANNIN ST # CC1410
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2316
Practice Address - Country:US
Practice Address - Phone:832-822-4565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31516104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker