=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730077249
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CHANDLAR COSKREY COUNSELING PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/24/2025
-----------------------------------------------------
Last Update Date | 06/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8700 MENCHACA RD STE 605
-----------------------------------------------------
City | AUSTIN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78748-5377
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-522-6370
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6500 MENCHACA RD UNIT 312
-----------------------------------------------------
City | AUSTIN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78745-4998
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | LEAD THERAPIST
-----------------------------------------------------
Name | CHANDLAR COSKREY
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 254-717-1739
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------