Provider Demographics
NPI:1295807576
Name:LOCKETT, VERNON EARL (LCSW)
Entity type:Individual
Prefix:MR
First Name:VERNON
Middle Name:EARL
Last Name:LOCKETT
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4126 WOODMONT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77045
Mailing Address - Country:US
Mailing Address - Phone:713-432-0381
Mailing Address - Fax:713-592-9461
Practice Address - Street 1:2626 SOUTH LOOP W
Practice Address - Street 2:SUITE 238
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2654
Practice Address - Country:US
Practice Address - Phone:713-432-0381
Practice Address - Fax:713-592-9461
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00514104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00596WMedicare ID - Type Unspecified