Provider Demographics
NPI:1629098405
Name:TRENCHARD, JAMES (JIM) E (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JAMES (JIM)
Middle Name:E
Last Name:TRENCHARD
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2313 TIMBER SHADOWS DR
Mailing Address - Street 2:SUITE103
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-2270
Mailing Address - Country:US
Mailing Address - Phone:281-540-1470
Mailing Address - Fax:281-540-2166
Practice Address - Street 1:1120 KINGWOOD DR
Practice Address - Street 2:SUITE 400
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-3043
Practice Address - Country:US
Practice Address - Phone:281-540-1470
Practice Address - Fax:281-540-2166
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX304991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX102764101Medicaid
TX102764101Medicaid
TX00876EMedicare ID - Type Unspecified