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General NPI Number Information
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NPI Number | 1609551860
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Entity Type | Organization
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Legal Business Name | CHALICE PSYCHOTHERAPIES, PLLC
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Dates
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Enumeration Date | 06/15/2023
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 9501 N CAPITAL OF TEXAS HWY STE 104
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City | AUSTIN
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State | TX
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Zip | 78759-7254
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Country | US
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Telephone | 737-471-9697
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Fax |
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Provider Business Mailing Address
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Address Line | 9500 JOLLYVILLE RD APT 140
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City | AUSTIN
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State | TX
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Zip | 78759-6524
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Country | US
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Telephone | 512-636-1333
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CINDY NOLAND
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Credential | LPC
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Telephone | 737-471-9697
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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