Provider Demographics
NPI:1780049411
Name:NDLOVU, QUICKSON (LCSW-S)
Entity type:Individual
Prefix:DR
First Name:QUICKSON
Middle Name:
Last Name:NDLOVU
Suffix:
Gender:M
Credentials:LCSW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4796
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-4796
Mailing Address - Country:US
Mailing Address - Phone:956-570-5110
Mailing Address - Fax:956-679-3040
Practice Address - Street 1:901 E HACKBERRY AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-6502
Practice Address - Country:US
Practice Address - Phone:956-618-7100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-22
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX564091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2X3158OtherMEDICARE