Provider Demographics
NPI:1497982409
Name:LEFFORGE, NAN (LCSW)
Entity type:Individual
Prefix:MS
First Name:NAN
Middle Name:
Last Name:LEFFORGE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4550 POST OAK PLACE DR
Mailing Address - Street 2:SUITE 352
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-3165
Mailing Address - Country:US
Mailing Address - Phone:713-840-0333
Mailing Address - Fax:713-840-0188
Practice Address - Street 1:4550 POST OAK PLACE DR
Practice Address - Street 2:SUITE 352
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-3165
Practice Address - Country:US
Practice Address - Phone:713-840-0333
Practice Address - Fax:713-840-0188
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-17
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX01639101YP2500X
102L00000X
TX35541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst