MEDICARE: MS. MARIA CHIO LPC-S, NCC,RPT

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	101YP2500X	Professional Counselor	LPC-S 18248	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	6533LC	OTHER	TX	BLUE CROSS BLUE SHIELD
2	10035139	OTHER	TX	AMERIGROUP

General Provider Information

NPI Number	:	1508878976
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARIA CHIO LPC-S, NCC,RPT

Provider Business Mailing Address
First Line	:	5005 W ROYAL LN
Second Line	:	SUITE 271
City	:	IRVING
State	:	TX
Zip	:	75063-2516
Country	:	US
Telephone Number	:	214-492-1975
Fax Number	:	214-492-1935

Provider Business Practice Location Address
First Line	:	5005 W ROYAL LN
Second Line	:	SUITE 271
City	:	IRVING
State	:	TX
Zip	:	75063-2516
Country	:	US
Telephone Number	:	214-492-1975
Fax Number	:	214-492-1935

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

Provider Enumeration Date	:	08/13/2006
Last Update Date	:	07/09/2007

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