Provider Demographics
NPI:1992337802
Name:VO, PHONG (LMSW)
Entity type:Individual
Prefix:
First Name:PHONG
Middle Name:
Last Name:VO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2016 MAIN ST APT 1415
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-8844
Mailing Address - Country:US
Mailing Address - Phone:281-781-5390
Mailing Address - Fax:
Practice Address - Street 1:1501 CROCKER STREET
Practice Address - Street 2:SUITE TWO
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77019
Practice Address - Country:US
Practice Address - Phone:832-559-2622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-08
Last Update Date:2020-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67285104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker