Provider Demographics
NPI:1578760112
Name:SAMISH, CECILIA ANN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CECILIA
Middle Name:ANN
Last Name:SAMISH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6300 WEST LOOP SOUTH 140
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-2913
Mailing Address - Country:US
Mailing Address - Phone:713-661-4332
Mailing Address - Fax:713-666-0134
Practice Address - Street 1:6300 WEST LOOP SOUTH 140
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-2913
Practice Address - Country:US
Practice Address - Phone:713-661-4332
Practice Address - Fax:713-666-0134
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX001874102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst