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NPI Code Detail

MEDICARE: MITZI SUZANNE MCBRIDE LCSW

MEDICARE:   MITZI SUZANNE MCBRIDE  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
11041C0700XClinical Social WorkerCSW6249TN
21041C0700XClinical Social WorkerLSW4740TN
31041C0700XClinical Social Worker69308TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1720086929
Entity Type Code : Individual
Provider Name (Legal Business Name) : MITZI SUZANNE MCBRIDE LCSW
Provider Business Mailing Address
First Line : 33130 MAGNOLIA CIR STE A1
Second Line :
City : MAGNOLIA
State : TX
Zip : 77354-3277
Country : US
Telephone Number : 832-422-5949
Fax Number :
Provider Business Practice Location Address
First Line : 33130 MAGNOLIA CIR STE A1
Second Line :
City : MAGNOLIA
State : TX
Zip : 77354-3277
Country : US
Telephone Number : 832-422-5949
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2005
Last Update Date : 09/24/2025

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Directions to “ MITZI SUZANNE MCBRIDE LCSW” Practice Location

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