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NPI Code Detail

MEDICARE: TRACEY REEVES LCSW

MEDICARE: TRACEY REEVES 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 Worker19823TX

General Provider Information

NPI Number : 1841370269
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRACEY REEVES LCSW
Provider Business Mailing Address
First Line : 6501 FANNIN ST # NB100
Second Line :
City : HOUSTON
State : TX
Zip : 77030-2703
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6501 FANNIN ST # NB100
Second Line :
City : HOUSTON
State : TX
Zip : 77030-2703
Country : US
Telephone Number : 713-798-4470
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2006
Last Update Date : 07/08/2007

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Directions to “ TRACEY REEVES LCSW” Practice Location

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