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NPI Code Detail

MEDICARE: JAN MORONG LCSW

MEDICARE: JAN MORONG 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
11041C0700XClinical Social Worker52911TX

General Provider Information

NPI Number : 1245465475
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAN MORONG LCSW
Provider Business Mailing Address
First Line : 4803 HILLDALE DR
Second Line :
City : AUSTIN
State : TX
Zip : 78723-6207
Country : US
Telephone Number : 512-368-1151
Fax Number :
Provider Business Practice Location Address
First Line : 4803 HILLDALE DR
Second Line :
City : AUSTIN
State : TX
Zip : 78723-6207
Country : US
Telephone Number : 512-368-1151
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2009
Last Update Date : 07/29/2016

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Directions to “ JAN MORONG LCSW” Practice Location

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