Provider Demographics
NPI:1144805714
Name:FLORES, SASHA ANNELIESA (LCSW)
Entity type:Individual
Prefix:
First Name:SASHA
Middle Name:ANNELIESA
Last Name:FLORES
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 1:3722 TRIPOLI DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78415-3345
Mailing Address - Country:US
Mailing Address - Phone:361-423-2442
Mailing Address - Fax:
Practice Address - Street 1:5151 FLYNN PKWY STE 412J
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-4372
Practice Address - Country:US
Practice Address - Phone:361-423-2442
Practice Address - Fax:361-356-3713
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-15
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX666931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical