Provider Demographics
NPI:1235331448
Name:CHASE, ALLISON K (PH D)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:K
Last Name:CHASE
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 S. CAPITAL OF TEXAS HWY.
Mailing Address - Street 2:BUILDING A, SUITE 295
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746
Mailing Address - Country:US
Mailing Address - Phone:512-347-9992
Mailing Address - Fax:512-329-5522
Practice Address - Street 1:1101 S CAPITAL OF TEXAS HWY
Practice Address - Street 2:BUILDING A, SUITE 295
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-6445
Practice Address - Country:US
Practice Address - Phone:512-347-9992
Practice Address - Fax:512-329-5522
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32120103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX32120OtherLICENSE NUMBER