Provider Demographics
NPI:1568548386
Name:LENGACHER, NYLA M (LCSW)
Entity Type:Individual
Prefix:MS
First Name:NYLA
Middle Name:M
Last Name:LENGACHER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2306 LAKE AUSTIN BLVD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78703-4546
Mailing Address - Country:US
Mailing Address - Phone:512-963-9718
Mailing Address - Fax:512-323-9222
Practice Address - Street 1:2306 LAKE AUSTIN BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78703-4546
Practice Address - Country:US
Practice Address - Phone:512-963-9718
Practice Address - Fax:512-323-9222
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX322591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0085LJOtherBC/BS OF TX
TXR15097Medicare UPIN
TX00324PMedicare ID - Type Unspecified