Provider Demographics
NPI:1689777856
Name:WILLINGHAM, HIROMI (LCSW)
Entity Type:Individual
Prefix:
First Name:HIROMI
Middle Name:
Last Name:WILLINGHAM
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 1:3406 HONEYLOCUST DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-2710
Mailing Address - Country:US
Mailing Address - Phone:713-516-6718
Mailing Address - Fax:
Practice Address - Street 1:14905 SOUTHWEST FWY
Practice Address - Street 2:SUITE 209
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-5099
Practice Address - Country:US
Practice Address - Phone:716-516-6718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2008-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX506281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical