Provider Demographics
NPI:1841438496
Name:CARRIZALES, RAUL (LCSW)
Entity type:Individual
Prefix:
First Name:RAUL
Middle Name:
Last Name:CARRIZALES
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:ROY
Other - Middle Name:
Other - Last Name:CARRIZALES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:5711 WIGHT CV
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-3205
Mailing Address - Country:US
Mailing Address - Phone:512-343-6737
Mailing Address - Fax:
Practice Address - Street 1:1106 CLAYTON LN
Practice Address - Street 2:242 WEST
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-1066
Practice Address - Country:US
Practice Address - Phone:512-567-5513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-04
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX525901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical