Desiderata Psychotherapy

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

32342 Issued in TX

Legal business name

DESIDERATA PSYCHOTHERAPY

Practice address

17719 Bamwood Dr
Houston, TX 77090-1852

Phone

(281) 203-1842

Fax

(832) 616-3460

NPI assigned

Oct 8, 2015

Last updated

Oct 8, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Veronica Mena Funke, LCSW

Title

Owner

Phone

(281) 203-1843

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1444262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444262400000",
    "number": "1285005868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17719 BAMWOOD DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770901852",
            "telephone_number": "281-203-1842",
            "fax_number": "832-616-3460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17719 BAMWOOD DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770901852",
            "telephone_number": "281-203-1842",
            "fax_number": "832-616-3460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESIDERATA PSYCHOTHERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-08",
        "last_updated": "2015-10-08",
        "status": "A",
        "authorized_official_last_name": "FUNKE",
        "authorized_official_first_name": "VERONICA",
        "authorized_official_middle_name": "MENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-203-1843",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "32342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Yash Deshpande
• Jerson Desiderio, O.D.
• Design Dental Group
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• Design Healthcare Services Inc.
• Erika Kristen Desimone, FNP-C

• Clinical Social Worker in Houston, TX
• Providers in Houston, 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 Oct 8, 2015; 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.