Provider Demographics
NPI:1912664863
Name:VENZANT, LAKETRIA (LCSW)
Entity Type:Individual
Prefix:
First Name:LAKETRIA
Middle Name:
Last Name:VENZANT
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 1:8813 N TARRANT PKWY STE 238
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76182-8461
Mailing Address - Country:US
Mailing Address - Phone:318-548-9748
Mailing Address - Fax:877-396-3330
Practice Address - Street 1:8813 N TARRANT PKWY STE 238
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76182-8461
Practice Address - Country:US
Practice Address - Phone:318-548-9748
Practice Address - Fax:877-396-3330
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-24
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1063641041C0700X, 251B00000X
LA138801041C0700X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator