Active NPI
Phyllis Iheanacho, LMSW
- Social Worker
- Richmond, TX
National Provider Identifier
1417533712
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 58830
- Practice address
- 1910 Teakwood St
Richmond, TX 77469-5413 - Phone
- (713) 517-2948
- NPI assigned
- Mar 18, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 58830 | TX | Primary |
Addresses
Primary practice location
1910 Teakwood St
Richmond, TX 77469-5413
Mailing address
12007 Merewood LN
Houston, TX 77071-2413
Phone (713) 517-2948
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 58830 | TX | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616025600000",
"number": "1417533712",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12007 MEREWOOD LN",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770712413",
"telephone_number": "713-517-2948"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1910 TEAKWOOD ST",
"city": "RICHMOND",
"state": "TX",
"postal_code": "774695413",
"telephone_number": "713-517-2948"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IHEANACHO",
"first_name": "PHYLLIS",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-03-18",
"last_updated": "2021-03-18",
"certification_date": "2021-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "TX",
"license": "58830",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richmond, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.