MEDICARE: MRS. NANCY LYNN EISENBERG MSW, 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	S12843	TX
2	106H00000X	Marriage & Family Therapist	001866	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	S12843	OTHER	TX	CLINICAL SOCIAL WORKER

General Provider Information

NPI Number	:	1477538833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NANCY LYNN EISENBERG MSW, LCSW, LMFT

Provider Business Mailing Address
First Line	:	12345 JONES RD
Second Line	:	SUITE, 101
City	:	HOUSTON
State	:	TX
Zip	:	77070-4855
Country	:	US
Telephone Number	:	281-890-5334
Fax Number	:	281-894-8611

Provider Business Practice Location Address
First Line	:	12345 JONES ROAD
Second Line	:	SUITE 101
City	:	HOUSTON
State	:	TX
Zip	:	77070-4855
Country	:	US
Telephone Number	:	281-890-5334
Fax Number	:	281-894-8611

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

Provider Enumeration Date	:	12/08/2005
Last Update Date	:	09/11/2025

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