MEDICARE: MARGARET PROCTOR 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	01621	TX
2	1041C0700X	Clinical Social Worker	LCSW-1272	WY

General Provider Information

NPI Number	:	1366700288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGARET PROCTOR LCSW

Provider Business Mailing Address
First Line	:	2116 THOMPSON RD
Second Line	:	SUITE 101
City	:	RICHMOND
State	:	TX
Zip	:	77469-5422
Country	:	US
Telephone Number	:	281-750-1794
Fax Number	:

Provider Business Practice Location Address
First Line	:	#14 GREAT PLAINS ROAD
Second Line	:
City	:	ARAPAHOE
State	:	WY
Zip	:	82501-8250
Country	:	US
Telephone Number	:	307-856-9281
Fax Number	:

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

Provider Enumeration Date	:	04/28/2012
Last Update Date	:	07/01/2021

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Directions to “ MARGARET PROCTOR LCSW” Practice Location

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