Provider Demographics
NPI:1518777887
Name:ANDERSON, LUCRETIA (CHW, CHWI, CD)
Entity type:Individual
Prefix:
First Name:LUCRETIA
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:CHW, CHWI, CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5818 GLENHURST DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77033-2008
Mailing Address - Country:US
Mailing Address - Phone:346-434-2709
Mailing Address - Fax:
Practice Address - Street 1:5818 GLEHURST DRIVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77033-2008
Practice Address - Country:US
Practice Address - Phone:346-434-2709
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-09
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No251B00000XAgenciesCase Management
No374J00000XNursing Service Related ProvidersDoula