MEDICARE: MAUNEY & ASSOCIATES, LLC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	7533	TX
2	251B00000X	Case Management Agency	34399	TX

General Provider Information

NPI Number	:	1730331166
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAUNEY & ASSOCIATES, LLC

Provider Business Mailing Address
First Line	:	P.O. BOX 351
Second Line	:
City	:	EVANT
State	:	TX
Zip	:	76525
Country	:	US
Telephone Number	:	254-471-5906
Fax Number	:

Provider Business Practice Location Address
First Line	:	752 COUNTY ROAD 417
Second Line	:
City	:	EVANT
State	:	TX
Zip	:	76525-2532
Country	:	US
Telephone Number	:	254-471-5906
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. MELISSA MAUNEY
Credential	:	LBSW-IPR, LCDC
Telephone Number	:	254-471-5906

Provider Enumeration Date	:	10/16/2008
Last Update Date	:	01/19/2011

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