Healthcare Provider Details

I. General information

NPI: 1497970370
Provider Name (Legal Business Name): MARCIA EMILY EYRICH LCSW, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8705 SHOAL CREEK BLVD SUITE 108
AUSTIN TX
78757-6802
US

IV. Provider business mailing address

8705 SHOAL CREEK BLVD SUITE 108
AUSTIN TX
78757-6802
US

V. Phone/Fax

Practice location:
  • Phone: 512-474-5852
  • Fax: 512-474-2925
Mailing address:
  • Phone: 512-474-5852
  • Fax: 512-474-2925

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW#9131 LPC #7777
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: