Individual provider Active NPI

Elizabeth Nickelson Reese Haine, LCSW

  • Clinical Social Worker
  • Houston, TX
National Provider Identifier
1871781591
Registry record updated Sep 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
35945 Issued in TX
Practice address
14133 Memorial Dr Ste 7
Houston, TX 77079-6800
Phone
(832) 230-1167
NPI assigned
Oct 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 35945 TX Primary

Addresses

Primary practice location

14133 Memorial Dr Ste 7
Houston, TX 77079-6800

Mailing address

8635 San Fernando Way
Dallas, TX 75218-4030
Phone (214) 827-0813

Other identifiers 1

IdentifierTypeStateIssuer
170304301MedicaidTX

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
35945TXMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
West Houston Counseling and Psychology, LLC Clinical CurrentSince Sep 11, 2022 Accepting new patients

Locations

14133 Memorial Dr
Ste 7
Houston, TX 77079
Phone (713) 309-6496

Organizations & group practices 1

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": "1191888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662336000000",
    "number": "1871781591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8635 SAN FERNANDO WAY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752184030",
            "telephone_number": "214-827-0813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14133 MEMORIAL DR STE 7",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770796800",
            "telephone_number": "832-230-1167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAINE",
        "first_name": "ELIZABETH",
        "middle_name": "NICKELSON REESE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-09",
        "last_updated": "2022-09-05",
        "certification_date": "2022-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "35945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170304301",
            "state": "TX"
        }
    ],
    "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 Sep 5, 2022; 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.