Organization
AUSTIN VITALITY COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLYE JOHNSTON LEVINE LCSW (MANAGER)
(512) 422-4352
Entity
Organization
Contact information
Practice address
12502 PALFREY DR, AUSTIN, TX 78727-3017
(512) 422-4352
Mailing address
12502 PALFREY DR, AUSTIN, TX 78727-3017
(512) 422-4352
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
52338
TX
Other
Enumeration date
04/23/2018
Last updated
04/23/2018
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