Provider Demographics
NPI:1396411443
Name:CAMPOS-ACOSTA, VERONICA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:VERONICA
Middle Name:
Last Name:CAMPOS-ACOSTA
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 1:1512 PRESERVE LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089-7059
Mailing Address - Country:US
Mailing Address - Phone:713-478-0332
Mailing Address - Fax:
Practice Address - Street 1:1512 PRESERVE LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089-7059
Practice Address - Country:US
Practice Address - Phone:713-478-0332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-18
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX567071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX56707OtherTEXAS BOARD OF BEHAVIORAL SCIENCES
CA99343OtherBOARD OF BEHAVIORAL SCIENCE