Provider Demographics
NPI:1619514536
Name:ACOSTA, ROSA (LCSW)
Entity Type:Individual
Prefix:
First Name:ROSA
Middle Name:
Last Name:ACOSTA
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 1:800 W SAM HOUSTON PKWY S STE 200
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-1914
Mailing Address - Country:US
Mailing Address - Phone:713-462-6565
Mailing Address - Fax:
Practice Address - Street 1:1615 HILLENDAHL BLVD STE 100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-3402
Practice Address - Country:US
Practice Address - Phone:713-462-6565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-10
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical