Provider Demographics
NPI:1013456367
Name:UCHECHUKWU, CAROL C (LCDC)
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:C
Last Name:UCHECHUKWU
Suffix:
Gender:F
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9950 WESTPARK DR STE 210
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-5199
Mailing Address - Country:US
Mailing Address - Phone:346-242-0275
Mailing Address - Fax:
Practice Address - Street 1:9950 WESTPARK DR STE 210
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-5199
Practice Address - Country:US
Practice Address - Phone:713-928-0337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-20
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX60871104100000X
TX16331101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX822282776Medicaid
TX37745808OtherDRIVER'S LICENSE