Provider Demographics
NPI:1609924885
Name:FLANAGAN, THERESA JOSEPHINE (LMSW-ACP)
Entity Type:Individual
Prefix:MS
First Name:THERESA
Middle Name:JOSEPHINE
Last Name:FLANAGAN
Suffix:
Gender:F
Credentials:LMSW-ACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5116 BISSONNET ST
Mailing Address - Street 2:SUITE 326
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-4007
Mailing Address - Country:US
Mailing Address - Phone:713-669-0373
Mailing Address - Fax:713-669-0217
Practice Address - Street 1:4545 BISSONNET ST
Practice Address - Street 2:SUITE 120
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3121
Practice Address - Country:US
Practice Address - Phone:713-669-0373
Practice Address - Fax:713-669-0217
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX23742104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00016EMedicare ID - Type Unspecified