MEDICARE: SHAYNA WAREING 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	57010	TX

General Provider Information

NPI Number	:	1760990501
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAYNA WAREING LCSW

Provider Business Mailing Address
First Line	:	9215 GEORGE KYLE ST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-3609
Country	:	US
Telephone Number	:	512-630-1185
Fax Number	:

Provider Business Practice Location Address
First Line	:	116 GALLERY CIR STE 201
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-3341
Country	:	US
Telephone Number	:	512-630-1185
Fax Number	:

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

Provider Enumeration Date	:	01/15/2018
Last Update Date	:	01/15/2018

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