Provider Demographics
NPI:1821680091
Name:BABAEI, TANYA R (LCSW)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:R
Last Name:BABAEI
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 1:4911 CAPESBROOK CT
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-2395
Mailing Address - Country:US
Mailing Address - Phone:713-894-6665
Mailing Address - Fax:
Practice Address - Street 1:4911 CAPESBROOK CT
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-2395
Practice Address - Country:US
Practice Address - Phone:713-894-6665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-09
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX523631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical