MEDICARE: MS. ELIZABETH EDITH STOLTE LMSW

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	101YM0800X	Mental Health Counselor	52547	TX
2	1041C0700X	Clinical Social Worker	52547	TX
3	171M00000X	Case Manager/Care Coordinator	52547	TX

General Provider Information

NPI Number	:	1073781712
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELIZABETH EDITH STOLTE LMSW

Provider Business Mailing Address
First Line	:	5700 NW CENTRAL DR STE 401-G
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77092-2039
Country	:	US
Telephone Number	:	361-210-8621
Fax Number	:

Provider Business Practice Location Address
First Line	:	5700 NW CENTRAL DR STE 401-G
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77092-2039
Country	:	US
Telephone Number	:	361-210-8621
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2008
Last Update Date	:	12/30/2022

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