Provider Demographics
NPI:1164138350
Name:ALLEN, ANTOINETTE R (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:ANTOINETTE
Middle Name:R
Last Name:ALLEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7667 CALLAGHAN RD APT 408
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-2762
Mailing Address - Country:US
Mailing Address - Phone:136-121-5121
Mailing Address - Fax:
Practice Address - Street 1:7667 CALLAGHAN RD APT 408
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-2762
Practice Address - Country:US
Practice Address - Phone:136-121-5121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX621401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical