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NPI Code Detail

MEDICARE: TRANSICARE, INC.

MEDICARE: TRANSICARE, INC.
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
1101YA0400XAddiction (Substance Use Disorder) Counselor
2103TA0400XAddiction (Substance Use Disorder) Psychologist
3103TC0700XClinical Psychologist
4171M00000XCase Manager/Care Coordinator
5343900000XNon-emergency Medical Transport (VAN)29069TX
6101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1609903483
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRANSICARE, INC.
Provider Business Mailing Address
First Line : 628 CENTRE ST STE B
Second Line :
City : DALLAS
State : TX
Zip : 75208-6328
Country : US
Telephone Number : 214-342-5800
Fax Number : 214-342-5801
Provider Business Practice Location Address
First Line : 628 CENTRE ST STE A
Second Line :
City : DALLAS
State : TX
Zip : 75208-6328
Country : US
Telephone Number : 214-367-6875
Fax Number : 972-354-0006
Authorized Official
Title or Position : CEO
Name : MR. TIMOTHY SCOTT BLACK
Credential : LMSW
Telephone Number : 214-342-5800
Provider Enumeration Date : 02/27/2007
Last Update Date : 12/12/2022

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