MEDICARE: TAIWANA M O'NEAL LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	37628	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	37628	OTHER	TX	TEXAS BEHAVIORAL HEALTH EXECUTIVE COUNCIL

General Provider Information

NPI Number	:	1770234387
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAIWANA M O'NEAL LCSW

Provider Business Mailing Address
First Line	:	11807 WESTHEIMER RD STE 550
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77077-6790
Country	:	US
Telephone Number	:	281-222-3884
Fax Number	:

Provider Business Practice Location Address
First Line	:	11807 WESTHEIMER RD STE 550
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77077-6790
Country	:	US
Telephone Number	:	832-617-6544
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/14/2022
Last Update Date	:	11/15/2023

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Directions to “ TAIWANA M O'NEAL LCSW” Practice Location

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