MEDICARE: REBECCA PETTERSSON 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	112422	TX

General Provider Information

NPI Number	:	1780528836
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA PETTERSSON LCSW

Provider Business Mailing Address
First Line	:	3520 MARIETTA LN
Second Line	:
City	:	SCHERTZ
State	:	TX
Zip	:	78154-1238
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6800 W IH 10 STE 200
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78201-2041
Country	:	US
Telephone Number	:	210-695-1900
Fax Number	:	714-276-2883

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

Provider Enumeration Date	:	04/17/2026
Last Update Date	:	04/17/2026

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Directions to “ REBECCA PETTERSSON LCSW” Practice Location

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