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NPI Code Detail

MEDICARE: CHANTA GOSBY LCSW

MEDICARE: CHANTA GOSBY LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker111460TX

General Provider Information

NPI Number : 1235062977
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHANTA GOSBY LCSW
Provider Business Mailing Address
First Line : 4524 MATTIE ST APT 207
Second Line :
City : AUSTIN
State : TX
Zip : 78723-5561
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1705 E 11TH ST
Second Line :
City : AUSTIN
State : TX
Zip : 78702-2709
Country : US
Telephone Number : 512-978-8400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2026
Last Update Date : 06/03/2026

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Directions to “ CHANTA GOSBY LCSW” Practice Location

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