MEDICARE: AMY MASON BIRK 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	104100000X	Social Worker	108623	TX

General Provider Information

NPI Number	:	1932801867
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY MASON BIRK LCSW

Provider Business Mailing Address
First Line	:	1222 COLUMBIA ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-7012
Country	:	US
Telephone Number	:	713-882-3712
Fax Number	:

Provider Business Practice Location Address
First Line	:	1115 YALE ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-6923
Country	:	US
Telephone Number	:	832-299-5159
Fax Number	:

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

Provider Enumeration Date	:	03/22/2023
Last Update Date	:	05/18/2026

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