Provider Demographics
NPI:1659870608
Name:CORTEZ, ALTHEA TARA RAUL (LCSW)
Entity Type:Individual
Prefix:
First Name:ALTHEA TARA
Middle Name:RAUL
Last Name:CORTEZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ALTHEA TARA
Other - Middle Name:RIVERA
Other - Last Name:RAUL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:10780 WESTVIEW DR STE C
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77043-5038
Mailing Address - Country:US
Mailing Address - Phone:713-932-5230
Mailing Address - Fax:
Practice Address - Street 1:10780 WESTVIEW DR STE C
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77043-5038
Practice Address - Country:US
Practice Address - Phone:713-932-5230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-06
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX592081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical