MEDICARE: REILLY COUNSELING PLLC

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	261QM0855X	Adolescent and Children Mental Health Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	41173	OTHER	TX	LCSW

General Provider Information

NPI Number	:	1770250326
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REILLY COUNSELING PLLC

Provider Business Mailing Address
First Line	:	6311 MILLWOOD CT
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76016-2666
Country	:	US
Telephone Number	:	682-777-3079
Fax Number	:	817-612-5792

Provider Business Practice Location Address
First Line	:	3901 W GREEN OAKS BLVD STE B
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76016-2789
Country	:	US
Telephone Number	:	682-777-3079
Fax Number	:	817-612-5792

Authorized Official
Title or Position	:	OWNER/LCSW-S
Name	:	MELISSA KATHLEEN ZAWISZA
Credential	:	LCSW-S
Telephone Number	:	682-777-3079

Provider Enumeration Date	:	08/23/2021
Last Update Date	:	02/10/2026

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