MEDICARE: HANNAH ELOVICH CASTLE 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	58184	TX

General Provider Information

NPI Number	:	1518474436
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNAH ELOVICH CASTLE LCSW

Provider Business Mailing Address
First Line	:	5237 ARBOLES DR APT H
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77035-2852
Country	:	US
Telephone Number	:	860-463-1817
Fax Number	:

Provider Business Practice Location Address
First Line	:	4306 YOAKUM BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77006-5851
Country	:	US
Telephone Number	:	860-463-1817
Fax Number	:	860-463-1817

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

Provider Enumeration Date	:	12/30/2017
Last Update Date	:	12/30/2017

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