Provider Demographics
NPI:1326177502
Name:SABLATURA, CLAUDELL COREY (LCSW)
Entity Type:Individual
Prefix:
First Name:CLAUDELL
Middle Name:COREY
Last Name:SABLATURA
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 1:10011 FOREST SPRING LN
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-3082
Mailing Address - Country:US
Mailing Address - Phone:281-485-9522
Mailing Address - Fax:281-485-9863
Practice Address - Street 1:2006 BROADWAY ST
Practice Address - Street 2:SUITE 104
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-5564
Practice Address - Country:US
Practice Address - Phone:281-485-9522
Practice Address - Fax:281-485-9863
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX154321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00552EMedicare ID - Type UnspecifiedTEXAS