Provider Demographics
NPI:1306645098
Name:TRAHAN, JAMIE BASS
Entity type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:BASS
Last Name:TRAHAN
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:JAMIE
Other - Middle Name:BASS
Other - Last Name:TRAHAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:4207 PURDUE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-1041
Mailing Address - Country:US
Mailing Address - Phone:713-816-0238
Mailing Address - Fax:
Practice Address - Street 1:4207 PURDUE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77005-1041
Practice Address - Country:US
Practice Address - Phone:713-816-0238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX593891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical