Healthcare Provider Details

I. General information

NPI: 1851777486
Provider Name (Legal Business Name): ELIZABETH SANTAMARIA BEFORT LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2015
Last Update Date: 06/24/2024
Certification Date: 06/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

472 PARK GROVE DR
KATY TX
77450-1571
US

IV. Provider business mailing address

21511 OAK PARK TRAILS DR
KATY TX
77450-5521
US

V. Phone/Fax

Practice location:
  • Phone: 713-540-6655
  • Fax:
Mailing address:
  • Phone: 713-540-6655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number60554
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: