Provider Demographics
NPI:1477147452
Name:SPEARS, KWAHERA (LCSW)
Entity Type:Individual
Prefix:
First Name:KWAHERA
Middle Name:
Last Name:SPEARS
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 1:4805 MONARCH DR
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75181-4957
Mailing Address - Country:US
Mailing Address - Phone:972-365-2230
Mailing Address - Fax:
Practice Address - Street 1:4805 MONARCH DR
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75181-4957
Practice Address - Country:US
Practice Address - Phone:972-365-2230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-22
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX582561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical