MEDICARE: VALERIE M WELLS 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	101YM0800X	Mental Health Counselor	62650	TX
2	1041C0700X	Clinical Social Worker	62650	TX

General Provider Information

NPI Number	:	1568133882
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALERIE M WELLS LCSW

Provider Business Mailing Address
First Line	:	7310 MENCHACA RD # 150911
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78745-5262
Country	:	US
Telephone Number	:	512-766-5209
Fax Number	:

Provider Business Practice Location Address
First Line	:	7310 MENCHACA RD # 150911
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78745-5262
Country	:	US
Telephone Number	:	512-766-5209
Fax Number	:

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

Provider Enumeration Date	:	09/27/2021
Last Update Date	:	12/29/2023

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Directions to “ VALERIE M WELLS LCSW” Practice Location

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