Mariyam Imtiaz, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

69713 Issued in TX

Practice address

147 Bella Katy Dr
Katy, TX 77494-6819

Phone

(832) 717-7166

Fax

(832) 717-9605

NPI assigned

Dec 29, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GCGBCD/Endpoint/GCGBCD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Greater Houston Counseling Services

  • Mental Health Counselor
  • Spring, TX
  • NPI 1295123909
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1703808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1093584179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 BELLA KATY DR",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774946819",
            "telephone_number": "832-717-7166",
            "fax_number": "832-717-9605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 BELLA KATY DR",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774946819",
            "telephone_number": "832-717-7166",
            "fax_number": "832-717-9605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMTIAZ",
        "first_name": "MARIYAM",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-29",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "69713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stella Grace Immanuel, MD
• Immediate Phlebotomy Service (I.P.S)
• Juliet Aliletu Imouokhome
• Impassioned Home Health Care, LLC
• Imperial Digestive Health Specialists PLLC
• In My Heart Counseling and Psychological Services
• In-Office Dental Specialists, PLLC (Wellspring Periodontics)
• Angelina In
• Lauren Inada
• Infinite Emerald Services LLC

• Clinical Social Worker in Katy, TX
• Providers in Katy, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.