Provider Demographics
NPI:1851537369
Name:AUSTIN, MICHAEL ANDRE (LCSW)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:ANDRE
Last Name:AUSTIN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 S SEMORAN BLVD
Mailing Address - Street 2:STE. 1093
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-5523
Mailing Address - Country:US
Mailing Address - Phone:407-678-9800
Mailing Address - Fax:407-315-0048
Practice Address - Street 1:1025 S SEMORAN BLVD
Practice Address - Street 2:STE. 1093
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-5523
Practice Address - Country:US
Practice Address - Phone:407-678-9800
Practice Address - Fax:407-315-0048
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-05
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 55611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical