Provider Demographics
NPI:1992388995
Name:FOXWORTH, SHAKESHIA (LCSW)
Entity Type:Individual
Prefix:
First Name:SHAKESHIA
Middle Name:
Last Name:FOXWORTH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SHAKESHIA
Other - Middle Name:
Other - Last Name:FOXWORTH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:6550 FANNIN ST
Mailing Address - Street 2:SUITE 1901
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030
Mailing Address - Country:US
Mailing Address - Phone:346-238-6288
Mailing Address - Fax:
Practice Address - Street 1:6550 FANNIN ST
Practice Address - Street 2:SUITE 1901
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:346-238-6288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-28
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX649041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical