Provider Demographics
NPI:1740217066
Name:NEIFERT, JOSEPH G (LCSW)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:G
Last Name:NEIFERT
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2718 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-5005
Mailing Address - Country:US
Mailing Address - Phone:713-732-0950
Mailing Address - Fax:
Practice Address - Street 1:2718 COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-5005
Practice Address - Country:US
Practice Address - Phone:713-732-0950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2013-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX361991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8D0971OtherBCBS OF TX
TX171132701Medicaid
8D0971Medicare ID - Type Unspecified
Q33294Medicare UPIN