Individual
JACK HOUSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW, LCDC
Contact information
Practice address
403 E 15TH ST, AUSTIN, TX 78701-1437
(512) 472-4357
(512) 703-1394
Mailing address
1430 COLLIER ST, AUSTIN, TX 78704-2911
(512) 472-4357
(512) 703-1394
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
11262
TX
1041C0700X
Clinical Social Worker
Primary
60367
TX
Other
Enumeration date
09/02/2011
Last updated
01/28/2019
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