MEDICARE: MS. KAREN LYNN PREWITT MA

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	106H00000X	Marriage & Family Therapist	003736-043069	TX
2	101YM0800X	Mental Health Counselor	10214	TX

General Provider Information

NPI Number	:	1912024845
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KAREN LYNN PREWITT MA

Provider Business Mailing Address
First Line	:	5825 CALLAGHAN RD STE 200
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78228-1107
Country	:	US
Telephone Number	:	210-521-4833
Fax Number	:	210-521-8561

Provider Business Practice Location Address
First Line	:	5825 CALLAGHAN RD STE 200
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78228-1107
Country	:	US
Telephone Number	:	210-521-4833
Fax Number	:	210-521-8561

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

Provider Enumeration Date	:	03/24/2007
Last Update Date	:	12/12/2017

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