Healthcare Provider Details

I. General information

NPI: 1619749694
Provider Name (Legal Business Name): CARLEY EXIGA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2023
Last Update Date: 10/24/2023
Certification Date: 10/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 MESA DR
PLAINVIEW TX
79072-3905
US

IV. Provider business mailing address

2703 OLD FORT RD
SUGAR LAND TX
77479-1779
US

V. Phone/Fax

Practice location:
  • Phone: 718-506-1115
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number68798
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: