Provider Demographics
NPI:1134796337
Name:NWOSU, LINYANTA J (JD, LCSW)
Entity type:Individual
Prefix:MS
First Name:LINYANTA
Middle Name:J
Last Name:NWOSU
Suffix:
Gender:F
Credentials:JD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 AUSTIN ST STE D
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-5275
Mailing Address - Country:US
Mailing Address - Phone:281-762-1663
Mailing Address - Fax:
Practice Address - Street 1:1000 AUSTIN ST STE D
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-5275
Practice Address - Country:US
Practice Address - Phone:281-762-1663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-07
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68908104100000X, 251B00000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty