Provider Demographics
NPI:1154128841
Name:PERSAUD, AVANI (LMSW)
Entity type:Individual
Prefix:
First Name:AVANI
Middle Name:
Last Name:PERSAUD
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 PROMENADE PKWY APT 170
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-1270
Mailing Address - Country:US
Mailing Address - Phone:832-306-5558
Mailing Address - Fax:
Practice Address - Street 1:555 PROMENADE PKWY APT 170
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-1270
Practice Address - Country:US
Practice Address - Phone:832-306-5558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-28
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111510104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker