Provider Demographics
NPI:1104522986
Name:PILES, TAIWAN DE'QUSIE (LPC-A, CRC, CVE)
Entity type:Individual
Prefix:
First Name:TAIWAN
Middle Name:DE'QUSIE
Last Name:PILES
Suffix:
Gender:F
Credentials:LPC-A, CRC, CVE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5206 ASTER RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:MANVEL
Mailing Address - State:TX
Mailing Address - Zip Code:77578-5393
Mailing Address - Country:US
Mailing Address - Phone:832-866-2719
Mailing Address - Fax:
Practice Address - Street 1:5206 ASTER RIDGE LN
Practice Address - Street 2:
Practice Address - City:MANVEL
Practice Address - State:TX
Practice Address - Zip Code:77578-5393
Practice Address - Country:US
Practice Address - Phone:832-866-2719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-03
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
499999225C00000X
TX93861101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX804878281Medicaid