Provider Demographics
NPI:1689326449
Name:PRICE, ARTESIA RENEE (LCSW)
Entity type:Individual
Prefix:
First Name:ARTESIA
Middle Name:RENEE
Last Name:PRICE
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 1:305 W COMMERCE ST APT 439
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-1995
Mailing Address - Country:US
Mailing Address - Phone:901-498-7994
Mailing Address - Fax:
Practice Address - Street 1:7502 FAIR OAKS AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-5404
Practice Address - Country:US
Practice Address - Phone:972-502-4140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-24
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN78831041C0700X
TX695851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical