MEDICARE: MS. JANICE MARIE PICHLER LPC/LCDC

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	09454	TX

General Provider Information

NPI Number	:	1588655211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JANICE MARIE PICHLER LPC/LCDC

Provider Business Mailing Address
First Line	:	511 BLAKELEY DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78209-5510
Country	:	US
Telephone Number	:	210-824-3297
Fax Number	:

Provider Business Practice Location Address
First Line	:	MCHE BMA 3851 ROGER BROOKE DR
Second Line	:	SUITE 3600
City	:	FORT SAM HOUSTON
State	:	TX
Zip	:	78234
Country	:	US
Telephone Number	:	210-295-4962
Fax Number	:	210-295-4751

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

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	07/08/2007

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