MEDICARE: HANNAH GOLUB 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	40256	TX

General Provider Information

NPI Number	:	1497121065
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HANNAH GOLUB LCSW

Provider Business Mailing Address
First Line	:	4119 MONTROSE BLVD
Second Line	:	SUITE 150
City	:	HOUSTON
State	:	TX
Zip	:	77006-4963
Country	:	US
Telephone Number	:	713-724-3516
Fax Number	:

Provider Business Practice Location Address
First Line	:	4119 MONTROSE BLVD
Second Line	:	SUITE 150
City	:	HOUSTON
State	:	TX
Zip	:	77006-4963
Country	:	US
Telephone Number	:	713-724-3516
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOTHERAPIST
Name	:	HANNAH SHULEVITZ GOLUB
Credential	:	LCSW
Telephone Number	:	713-724-3516

Provider Enumeration Date	:	08/18/2015
Last Update Date	:	08/18/2015

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