Provider Demographics
NPI:1710570858
Name:CHASTAIN, ERYN MAREE (LCSW)
Entity Type:Individual
Prefix:
First Name:ERYN
Middle Name:MAREE
Last Name:CHASTAIN
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 1:12915 JONES MALTSBERGER RD STE 201
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247-4540
Mailing Address - Country:US
Mailing Address - Phone:210-664-2135
Mailing Address - Fax:
Practice Address - Street 1:12915 JONES MALTSBERGER RD STE 201
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78247-4540
Practice Address - Country:US
Practice Address - Phone:210-664-2135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-19
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX665411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical