Provider Demographics
NPI:1346748514
Name:SOTTILE, CHESTER P (MA, LPC)
Entity Type:Individual
Prefix:MR
First Name:CHESTER
Middle Name:P
Last Name:SOTTILE
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 GREEN EMERALD TER
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78739-7616
Mailing Address - Country:US
Mailing Address - Phone:512-327-5040
Mailing Address - Fax:
Practice Address - Street 1:3536 BEE CAVES RD STE 100
Practice Address - Street 2:
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-5474
Practice Address - Country:US
Practice Address - Phone:512-327-5040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-23
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16472101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional