Provider Demographics
NPI:1275705626
Name:JOHN, BIJU (LMSW)
Entity Type:Individual
Prefix:
First Name:BIJU
Middle Name:
Last Name:JOHN
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14223 NELSON BAY COURT
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478
Mailing Address - Country:US
Mailing Address - Phone:281-757-3070
Mailing Address - Fax:281-240-2428
Practice Address - Street 1:14223 NELSON BAY COURT
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478
Practice Address - Country:US
Practice Address - Phone:281-757-3070
Practice Address - Fax:281-240-2428
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-26
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32446104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker