Provider Demographics
NPI:1386322477
Name:EKWEM, ADAEZE JAZINTA (MBA)
Entity type:Individual
Prefix:MS
First Name:ADAEZE
Middle Name:JAZINTA
Last Name:EKWEM
Suffix:
Gender:
Credentials:MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9639 HILLCROFT ST # 1029
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-3805
Mailing Address - Country:US
Mailing Address - Phone:832-987-4663
Mailing Address - Fax:
Practice Address - Street 1:14702 WYNBOURN WAY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-4701
Practice Address - Country:US
Practice Address - Phone:832-987-4663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-07
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No171W00000XOther Service ProvidersContractor