Provider Demographics
NPI:1578575155
Name:LOUIS, TIMOTHY ALAN (LCSW)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:ALAN
Last Name:LOUIS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6023 ROSE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-5009
Mailing Address - Country:US
Mailing Address - Phone:713-818-3173
Mailing Address - Fax:
Practice Address - Street 1:3815 MONTROSE BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-4664
Practice Address - Country:US
Practice Address - Phone:713-802-7854
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10671041C0700X
TX281-273106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX81214WMedicare ID - Type UnspecifiedMEDICARE NUMBER