MEDICARE: MS. ELIZABETH CERECERES MSW, 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	115784	TX
2	1041C0700X	Clinical Social Worker	LCSW-5325-0	HI

General Provider Information

NPI Number	:	1770479438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELIZABETH CERECERES MSW, LCSW

Provider Business Mailing Address
First Line	:	5522 LONE STAR PKWY STE 303
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78253-6722
Country	:	US
Telephone Number	:	254-813-8809
Fax Number	:	210-614-4990

Provider Business Practice Location Address
First Line	:	4727 BENDING GRV
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78259-2289
Country	:	US
Telephone Number	:	254-813-8809
Fax Number	:

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

Provider Enumeration Date	:	06/17/2025
Last Update Date	:	03/04/2026

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