Individual provider Active NPI

Andrew Etuk, LCSW

  • Clinical Social Worker
  • Houston, TX
National Provider Identifier
1982099511
Registry record updated Nov 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
52847 Issued in TX
Practice address
10333 Harwin Dr 535D
Houston, TX 77036-1532
Phone
(713) 482-1029
NPI assigned
Mar 31, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2015

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 52847 TX Primary

Addresses

Primary practice location

10333 Harwin Dr 535D
Houston, TX 77036-1532

Mailing address

10333 Harwin Dr 535D
Houston, TX 77036-1532
Phone (713) 482-1029

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1427760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446422400000",
    "number": "1982099511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10333 HARWIN DR 535D",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770361532",
            "telephone_number": "713-482-1029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10333 HARWIN DR 535D",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770361532",
            "telephone_number": "713-482-1029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETUK",
        "first_name": "ANDREW",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-31",
        "last_updated": "2015-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "52847",
            "primary": true
        }
    ],
    "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 Nov 2, 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.