Provider Demographics
NPI:1073810503
Name:JUBERT, ELEANOR (LMSW)
Entity Type:Individual
Prefix:MS
First Name:ELEANOR
Middle Name:
Last Name:JUBERT
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 1:3420 VETERANS CIR
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77707-2552
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15115 PARK ROW
Practice Address - Street 2:110
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-4947
Practice Address - Country:US
Practice Address - Phone:866-409-0039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-18
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41465104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker