Organization
MAGELLAN
Active
Other names
CAQH
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CYNTHIA A SCHMITZ (PROVIDER RELATION SPECIALIST)
(314) 387-5373
Entity
Organization
Contact information
Practice address
1200 BARTON HILLS DR APT 260, AUSTIN, TX 78704-1913
(254) 371-6844
Mailing address
1200 BARTON HILLS DR APT 260, AUSTIN, TX 78704-1913
(254) 371-6844
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
08078
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08078
LICENSED CLINICAL SOCIAL WORKER
TX
01
—
10780
LICENSED CHEMICAL DEPENDENCY COUNSELOR
TX
Enumeration date
01/14/2015
Last updated
01/14/2015
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