Healthcare Provider Details

I. General information

NPI: 1316198013
Provider Name (Legal Business Name): MEAGHAN HOUSE ESCARENO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2008
Last Update Date: 05/13/2021
Certification Date: 05/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 ROSEWOOD AVE
AUSTIN TX
78702-2023
US

IV. Provider business mailing address

PO BOX 326
DRIFTWOOD TX
78619-0326
US

V. Phone/Fax

Practice location:
  • Phone: 512-765-4916
  • Fax:
Mailing address:
  • Phone: 314-650-0239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number51823
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: