Provider Demographics
NPI:1114736790
Name:HORENBLAS, LIAN (LCSW)
Entity type:Individual
Prefix:
First Name:LIAN
Middle Name:
Last Name:HORENBLAS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1828 PORTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76102-1531
Mailing Address - Country:US
Mailing Address - Phone:971-678-2025
Mailing Address - Fax:
Practice Address - Street 1:1828 PORTLAND AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76102-1531
Practice Address - Country:US
Practice Address - Phone:971-678-2025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX657481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical