=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477538833
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NANCY LYNN EISENBERG MSW, LCSW, LMFT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/08/2005
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12345 JONES ROAD SUITE 101
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77070-4855
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-890-5334
-----------------------------------------------------
Fax | 281-894-8611
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12345 JONES RD SUITE, 101
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77070-4855
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-890-5334
-----------------------------------------------------
Fax | 281-894-8611
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | S12843
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | 001866
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------