MEDICARE: ANGELICA PICADO-SINCLAIR

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	68948	TX

General Provider Information

NPI Number	:	1558841247
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELICA PICADO-SINCLAIR

Provider Business Mailing Address
First Line	:	3508 W HOLLYWOOD AVE APT 2
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60659-4422
Country	:	US
Telephone Number	:	414-303-3995
Fax Number	:

Provider Business Practice Location Address
First Line	:	1311 CHISHOLM TRAIL RD STE 402
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-2970
Country	:	US
Telephone Number	:	512-650-8085
Fax Number	:

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

Provider Enumeration Date	:	08/21/2018
Last Update Date	:	01/05/2024

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