Provider Demographics
NPI:1255664751
Name:JAMES, BERNICE LEONA (LCSW)
Entity Type:Individual
Prefix:
First Name:BERNICE
Middle Name:LEONA
Last Name:JAMES
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 1:28919 PECAN CIR
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77381-1133
Mailing Address - Country:US
Mailing Address - Phone:281-635-5628
Mailing Address - Fax:281-367-1768
Practice Address - Street 1:28919 PECAN CIR
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77381-1133
Practice Address - Country:US
Practice Address - Phone:281-635-5628
Practice Address - Fax:281-367-1768
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-15
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSW307791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical