MEDICARE: RACHEL GLASER LCSW, PLLC

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	53056	TX

General Provider Information

NPI Number	:	1376994061
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RACHEL GLASER LCSW, PLLC

Provider Business Mailing Address
First Line	:	1619 W 6TH ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78703-5059
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1619 W 6TH ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78703-5059
Country	:	US
Telephone Number	:	504-228-3168
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	RACHEL GLASER
Credential	:	LCSW
Telephone Number	:	504-228-3168

Provider Enumeration Date	:	06/24/2016
Last Update Date	:	09/19/2016

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