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NPI Code Detail

MEDICARE: ERIN PEACE LCSW

MEDICARE: ERIN PEACE 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
1101YM0800XMental Health Counselor64341TX
21041C0700XClinical Social Worker64341TX

General Provider Information

NPI Number : 1538788740
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIN PEACE LCSW
Provider Business Mailing Address
First Line : 8956 RESEARCH BLVD BLDG 2
Second Line :
City : AUSTIN
State : TX
Zip : 78758-5969
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8956 RESEARCH BLVD BLDG 2
Second Line :
City : AUSTIN
State : TX
Zip : 78758-5969
Country : US
Telephone Number : 512-451-7337
Fax Number : 512-451-8729
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2020
Last Update Date : 04/09/2020

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Directions to “ ERIN PEACE LCSW” Practice Location

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