MEDICARE: MS. LUCILLE ALLENE ARMSTRONG LCSW, LMFT

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	00108	TX
2	106H00000X	Marriage & Family Therapist	2127	TX

General Provider Information

NPI Number	:	1194052894
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LUCILLE ALLENE ARMSTRONG LCSW, LMFT

Provider Business Mailing Address
First Line	:	4702 ZANES CT
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75052-1748
Country	:	US
Telephone Number	:	214-236-3440
Fax Number	:

Provider Business Practice Location Address
First Line	:	4702 ZANES CT
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75052-1748
Country	:	US
Telephone Number	:	214-236-3440
Fax Number	:

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

Provider Enumeration Date	:	11/17/2009
Last Update Date	:	11/17/2009

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