Provider Demographics
NPI:1609202100
Name:CHERIYAN, SUJA V (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SUJA
Middle Name:V
Last Name:CHERIYAN
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 1:19901 SOUTHWEST FWY
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-6538
Mailing Address - Country:US
Mailing Address - Phone:281-207-1295
Mailing Address - Fax:
Practice Address - Street 1:2400 AUGUSTA DR
Practice Address - Street 2:SUITE 372
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-4922
Practice Address - Country:US
Practice Address - Phone:713-785-7575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-17
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX317731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical