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General NPI Number Information
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NPI Number | 1992739502
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Entity Type | Individual
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Provider Name | EDWARD LOUIS PACETTI JR. LCSW
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Gender | Male
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 05/09/2024
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Provider Practice Location Address
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Address Line | 4203 WOODCOCK DR SUITE 265
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City | SAN ANTONIO
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State | TX
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Zip | 78228-1320
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Country | US
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Telephone | 210-683-3810
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Fax | 210-695-7702
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Provider Business Mailing Address
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Address Line | 214 RENNER DR
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City | SAN ANTONIO
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State | TX
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Zip | 78201-2727
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Country | US
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Telephone | 210-683-3810
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 23763
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License Number State | TX
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