Provider Demographics
NPI:1336637156
Name:NWOKEM, BIANCA (LCSW)
Entity Type:Individual
Prefix:
First Name:BIANCA
Middle Name:
Last Name:NWOKEM
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 1:1819 AUGUSTA DR APT 446
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-3142
Mailing Address - Country:US
Mailing Address - Phone:281-894-1423
Mailing Address - Fax:
Practice Address - Street 1:1819 AUGUSTA DR APT 446
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-3142
Practice Address - Country:US
Practice Address - Phone:281-894-1423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-26
Last Update Date:2023-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1042461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical