Provider Demographics
NPI:1205957560
Name:ARENTSEN-LANDGREN, MARGARITA INGEBORG (LCSW-S, LCDC, ADC)
Entity type:Individual
Prefix:
First Name:MARGARITA
Middle Name:INGEBORG
Last Name:ARENTSEN-LANDGREN
Suffix:
Gender:F
Credentials:LCSW-S, LCDC, ADC
Other - Prefix:
Other - First Name:MARGARITA
Other - Middle Name:INGEBORG
Other - Last Name:ARENTSEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LICSW
Mailing Address - Street 1:5112 MIMOSA DR
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-4941
Mailing Address - Country:US
Mailing Address - Phone:832-341-7633
Mailing Address - Fax:866-623-7085
Practice Address - Street 1:5112 MIMOSA DR
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-4941
Practice Address - Country:US
Practice Address - Phone:832-341-7633
Practice Address - Fax:866-623-7085
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14960101YA0400X
RIISW034291041C0700X
TX501031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIISW03429OtherLICSW
TX14960OtherLCDC, ADC
TX50103OtherLCSW-S