MEDICARE: MRS. ELIZABETH SPENCER CALLAWAY LPC LMFT LCDC SPMA

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	3206	TX
2	101YP2500X	Professional Counselor	2906	TX
3	106H00000X	Marriage & Family Therapist	81	TX

General Provider Information

NPI Number	:	1639288384
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELIZABETH SPENCER CALLAWAY LPC LMFT LCDC SPMA

Provider Business Mailing Address
First Line	:	8600 WURZBACH
Second Line	:	SUITE 1103
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240
Country	:	US
Telephone Number	:	210-822-5971
Fax Number	:	830-336-4668

Provider Business Practice Location Address
First Line	:	8600 WURZBACH
Second Line	:	SUITE 1103
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240
Country	:	US
Telephone Number	:	210-822-5971
Fax Number	:	830-336-4668

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

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	09/11/2025

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