Provider Demographics
NPI:1346029451
Name:KINGSLEY, THORA ANSELL (LMSW)
Entity Type:Individual
Prefix:
First Name:THORA
Middle Name:ANSELL
Last Name:KINGSLEY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5822 DRYAD DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77035-4209
Mailing Address - Country:US
Mailing Address - Phone:713-492-3868
Mailing Address - Fax:
Practice Address - Street 1:6210 ROOKIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-3718
Practice Address - Country:US
Practice Address - Phone:713-526-2046
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-27
Last Update Date:2023-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1113981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical