MEDICARE: LINDA CHASE, LCSW, PLLC

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	1041C0700X	Clinical Social Worker	32193	TX

General Provider Information

NPI Number	:	1427555457
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINDA CHASE, LCSW, PLLC

Provider Business Mailing Address
First Line	:	4119 MONTROSE BLVD STE 220
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77006-4964
Country	:	US
Telephone Number	:	713-533-9335
Fax Number	:

Provider Business Practice Location Address
First Line	:	4119 MONTROSE BLVD STE 220
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77006-4964
Country	:	US
Telephone Number	:	713-533-9335
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LINDA Y CHASE
Credential	:
Telephone Number	:	713-533-9335

Provider Enumeration Date	:	04/06/2018
Last Update Date	:	04/06/2018

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