Provider Demographics
NPI:1215660501
Name:OBI, CHEZAMETHYST (LCSW)
Entity type:Individual
Prefix:MS
First Name:CHEZAMETHYST
Middle Name:
Last Name:OBI
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 1:8530 FM 1960 RD E STE 117
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-1831
Mailing Address - Country:US
Mailing Address - Phone:281-713-9004
Mailing Address - Fax:281-973-2494
Practice Address - Street 1:8530 FM 1960 RD E STE 107
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-1831
Practice Address - Country:US
Practice Address - Phone:281-713-9004
Practice Address - Fax:281-973-2494
Is Sole Proprietor?:No
Enumeration Date:2022-07-05
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108165101YP2500X, 104100000X, 171M00000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator