Provider Demographics
NPI:1699700153
Name:LOCKER, LOUISE THOMSON I (MSW,LCSW)
Entity type:Individual
Prefix:
First Name:LOUISE
Middle Name:THOMSON
Last Name:LOCKER
Suffix:I
Gender:F
Credentials:MSW,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 LARCHMONT DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-4271
Mailing Address - Country:US
Mailing Address - Phone:210-829-1467
Mailing Address - Fax:
Practice Address - Street 1:240 LARCHMONT DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-4271
Practice Address - Country:US
Practice Address - Phone:210-829-1467
Practice Address - Fax:210-829-1467
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX043661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX02MJOtherBCBS
TX151865601Medicaid