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NPI Code Detail

MEDICARE: MARGO RICHDALE CASE LCSW

MEDICARE: MARGO RICHDALE CASE 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 Worker39701TX

General Provider Information

NPI Number : 1952469934
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARGO RICHDALE CASE LCSW
Provider Business Mailing Address
First Line : 2876 PASO DEL ROBLES
Second Line :
City : SAN MARCOS
State : TX
Zip : 78666-1001
Country : US
Telephone Number : 512-396-8540
Fax Number : 512-386-5680
Provider Business Practice Location Address
First Line : 101 UHLAND RD STE 202
Second Line :
City : SAN MARCOS
State : TX
Zip : 78666-6681
Country : US
Telephone Number : 512-396-8540
Fax Number : 512-396-5680
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2006
Last Update Date : 06/09/2008

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Directions to “ MARGO RICHDALE CASE LCSW” Practice Location

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