Provider Demographics
NPI:1396250486
Name:HOUSTON, V. LASHAWNE (LMSW)
Entity type:Individual
Prefix:MS
First Name:V. LASHAWNE
Middle Name:
Last Name:HOUSTON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 MANCHESTER ST
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06112-1347
Mailing Address - Country:US
Mailing Address - Phone:860-997-5179
Mailing Address - Fax:
Practice Address - Street 1:2550 MAIN ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06120-1936
Practice Address - Country:US
Practice Address - Phone:860-724-1223
Practice Address - Fax:860-724-1225
Is Sole Proprietor?:No
Enumeration Date:2017-12-11
Last Update Date:2017-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT038-499946104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1932658960OtherHARTFORD COMMUNITIES THAT CARE, INC.