MEDICARE: AMY ESKELSEN MSW, LCSW

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	109229	TX

General Provider Information

NPI Number	:	1174930697
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY ESKELSEN MSW, LCSW

Provider Business Mailing Address
First Line	:	PO BOX 821
Second Line	:
City	:	LEANDER
State	:	TX
Zip	:	78646-0821
Country	:	US
Telephone Number	:	360-205-5965
Fax Number	:

Provider Business Practice Location Address
First Line	:	13341 W HWY 290 STE 1-105
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78737-9160
Country	:	US
Telephone Number	:	512-640-2559
Fax Number	:

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

Provider Enumeration Date	:	07/16/2014
Last Update Date	:	12/15/2023

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