# EARLE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** C. JASON EARLE, LCSW
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518330554
- **Authorized official:** CHARLES JASON EARLE LCSW (DIRECTOR)
- **Authorized official phone:** (855) 553-2783

## Contact information

- **Practice address:** 4100 AVENUE D, AUSTIN, TX 78751
- **Practice address phone:** (855) 553-2783
- **Practice address fax:** (855) 553-2783
- **Mailing address:** 1101 W 34TH ST STE 256, AUSTIN, TX 78705-1907
- **Mailing address phone:** (855) 553-2753
- **Mailing address fax:** (855) 553-2753

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |

## Other

- **Enumeration date:** 11/12/2015
- **Last updated:** 01/22/2025