Provider Demographics
NPI:1750157897
Name:MAMOMBE, FAITH COMFORT (LCSW)
Entity type:Individual
Prefix:MS
First Name:FAITH
Middle Name:COMFORT
Last Name:MAMOMBE
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 1:6927 SCENIC SUNSET
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-3515
Mailing Address - Country:US
Mailing Address - Phone:251-751-9133
Mailing Address - Fax:
Practice Address - Street 1:9821 CAMINO VILLA APT 537
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78254-5623
Practice Address - Country:US
Practice Address - Phone:251-751-9133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-29
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX689471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical