Healthcare Provider Details

I. General information

NPI: 1457038051
Provider Name (Legal Business Name): VANESHIA LADAMA SLEDGE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VANESHIA FORD ASW

II. Dates (important events)

Enumeration Date: 07/05/2023
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16703 TWISTED PINE DR
CONROE TX
77302-2307
US

IV. Provider business mailing address

16703 TWISTED PINE DR
CONROE TX
77302-2307
US

V. Phone/Fax

Practice location:
  • Phone: 706-590-0225
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number137830
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number119973
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: