Healthcare Provider Details

I. General information

NPI: 1780303503
Provider Name (Legal Business Name): AYSHA HUSSAINI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AYSHA HUSSAINI-STEWART LCSW

II. Dates (important events)

Enumeration Date: 08/24/2022
Last Update Date: 10/30/2023
Certification Date: 10/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12234 SHADOW CREEK PKWY STE 106
PEARLAND TX
77584-7330
US

IV. Provider business mailing address

1345 SPACE PARK DR STE C
HOUSTON TX
77058-3469
US

V. Phone/Fax

Practice location:
  • Phone: 346-206-3992
  • Fax: 832-652-3626
Mailing address:
  • Phone: 281-333-2284
  • Fax: 281-333-0221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number103516
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number103516
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: