Individual provider Active NPI

Dezaree' La' Destiny Lusk, LCSW

  • Clinical Social Worker
  • Houston, TX
National Provider Identifier
1447754148
Registry record updated May 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
62594 Issued in TX
Practice address
8950 Westpark Dr Ste 118
Houston, TX 77063-5502
Phone
(469) 499-6200
NPI assigned
Mar 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 62594 TX Primary
Prosthetics Case Management 1744P3200X 1449535 TX

Addresses

Primary practice location

8950 Westpark Dr Ste 118
Houston, TX 77063-5502

Mailing address

905 Macaw Way
Desoto, TX 75115-7210
Phone (469) 499-6200

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

LicenseStateTypeSpecialty
1449535TXMDProsthetics Case Management
62594TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Divine Beauty Bar, LLC Prosthetics Case Management CurrentSince Dec 17, 2023 Accepting new patients
Z.E. Freight Dispatch Services and Operations, LLC CurrentSince Jan 2, 2022 Accepting new patients
A Divine Connection Child Placing Agency, LLC CurrentSince Jan 2, 2022 Accepting new patients

Locations

4201 Cypress Creek Pkwy
Ste 322
Houston, TX 77068
Phone (469) 499-6200

8950 Westpark Dr
Ste 118
Houston, TX 77063
Phone (469) 499-6200

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1521417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620432000000",
    "number": "1447754148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 MACAW WAY",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751157210",
            "telephone_number": "469-499-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8950 WESTPARK DR STE 118",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770635502",
            "telephone_number": "469-499-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSK",
        "first_name": "DEZAREE'",
        "middle_name": "LA' DESTINY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-19",
        "last_updated": "2021-05-08",
        "certification_date": "2021-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "62594",
            "primary": true
        },
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "TX",
            "license": "1449535",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.

Verify at the official NPI Registry.