MEDICARE: FABEAIN DAMONTE BARKWELL 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	1041C0700X	Clinical Social Worker	65021	TX

General Provider Information

NPI Number	:	1568195220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FABEAIN DAMONTE BARKWELL LCSW

Provider Business Mailing Address
First Line	:	701 FM 685 STE 450
Second Line	:
City	:	PFLUGERVILLE
State	:	TX
Zip	:	78660-2899
Country	:	US
Telephone Number	:	512-379-7728
Fax Number	:

Provider Business Practice Location Address
First Line	:	701 FM 685 STE 450
Second Line	:
City	:	PFLUGERVILLE
State	:	TX
Zip	:	78660-7095
Country	:	US
Telephone Number	:	512-379-7728
Fax Number	:

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

Provider Enumeration Date	:	07/08/2022
Last Update Date	:	05/09/2023

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