MEDICARE: STRENGTH IN ACTION LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1003434150
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STRENGTH IN ACTION LLC

Provider Business Mailing Address
First Line	:	5941 FIESTA DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-5254
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5941 FIESTA DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-5254
Country	:	US
Telephone Number	:	915-412-0468
Fax Number	:

Authorized Official
Title or Position	:	LCSW
Name	:	DARYL STEVENS
Credential	:
Telephone Number	:	915-412-0468

Provider Enumeration Date	:	07/06/2020
Last Update Date	:	07/06/2020

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Directions to “STRENGTH IN ACTION LLC ” Practice Location

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