MEDICARE: BRANDI COUCH LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	52385	TX
2	1041C0700X	Clinical Social Worker	52385	TX

General Provider Information

NPI Number	:	1154993624
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDI COUCH LCSW

Provider Business Mailing Address
First Line	:	9503 CAGLE DR
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79119-1393
Country	:	US
Telephone Number	:	806-214-7413
Fax Number	:

Provider Business Practice Location Address
First Line	:	9503 CAGLE DR
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79119-1393
Country	:	US
Telephone Number	:	806-214-7413
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2021
Last Update Date	:	05/13/2026

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Directions to “ BRANDI COUCH LCSW” Practice Location

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