Provider Demographics
NPI:1881788545
Name:CHANDLER, MICHELE (LCSW)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:CHANDLER
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 1:5900 SOUTHWEST PKWY STE 420
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-6202
Mailing Address - Country:US
Mailing Address - Phone:512-709-6304
Mailing Address - Fax:
Practice Address - Street 1:5900 SOUTHWEST PKWY STE 420
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735-6202
Practice Address - Country:US
Practice Address - Phone:512-762-3663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX108219003Medicaid
8L10625Medicare PIN