MEDICARE: ALANNA WOOLSEY 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	1041C0700X	Clinical Social Worker	61002	TX

General Provider Information

NPI Number	:	1740672955
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALANNA WOOLSEY LCSW

Provider Business Mailing Address
First Line	:	8080 N CENTRAL EXPY
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75206-1838
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8080 N CENTRAL EXPY
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75206-1838
Country	:	US
Telephone Number	:	972-860-8600
Fax Number	:

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

Provider Enumeration Date	:	02/25/2015
Last Update Date	:	09/29/2015

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