MEDICARE: MRS. AMELIA H LEONY-CARRETE 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	38853	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205018827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMELIA H LEONY-CARRETE LCSW

Provider Business Mailing Address
First Line	:	1855 TRAWOOD DR.
Second Line	:	SUITE 107
City	:	EL PASO
State	:	TX
Zip	:	79936-3112
Country	:	US
Telephone Number	:	915-593-2000
Fax Number	:	915-593-2002

Provider Business Practice Location Address
First Line	:	1855 TRAWOOD DR.
Second Line	:	SUITE 107
City	:	EL PASO
State	:	TX
Zip	:	79936-3112
Country	:	US
Telephone Number	:	915-593-2000
Fax Number	:	915-593-2002

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

Provider Enumeration Date	:	12/05/2007
Last Update Date	:	07/24/2012

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