Provider Demographics
NPI:1679804397
Name:SHUGART, CHASITY JANE (LCSW)
Entity Type:Individual
Prefix:
First Name:CHASITY
Middle Name:JANE
Last Name:SHUGART
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 1:1400 NIH 35 LL STE.400
Mailing Address - Street 2:PAUL BASS CLINIC
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701
Mailing Address - Country:US
Mailing Address - Phone:512-324-7000
Mailing Address - Fax:512-324-8071
Practice Address - Street 1:1400 NIH 35 LL STE.400
Practice Address - Street 2:PAUL BASS CLINIC
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701
Practice Address - Country:US
Practice Address - Phone:512-324-7000
Practice Address - Fax:512-324-8071
Is Sole Proprietor?:No
Enumeration Date:2010-01-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX361911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical