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NPI Code Detail

MEDICARE: RACHEL BURGREEN LCSW-S

MEDICARE:   RACHEL  BURGREEN  LCSW-S
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
1104100000XSocial Worker56555TX

General Provider Information

NPI Number : 1477969517
Entity Type Code : Individual
Provider Name (Legal Business Name) : RACHEL BURGREEN LCSW-S
Provider Business Mailing Address
First Line : 105 DEEN AVE
Second Line :
City : AUSTIN
State : TX
Zip : 78753-5401
Country : US
Telephone Number : 512-703-0650
Fax Number :
Provider Business Practice Location Address
First Line : 105 DEEN AVE
Second Line :
City : AUSTIN
State : TX
Zip : 78753-5401
Country : US
Telephone Number : 512-703-0650
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2014
Last Update Date : 11/28/2022

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Directions to “ RACHEL BURGREEN LCSW-S” Practice Location

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