MEDICARE: MR. CHARLES EUGENE AUSTIN L.C.S.W., L.C.D.C.

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	1838	TX
2	1041C0700X	Clinical Social Worker	18563	TX

General Provider Information

NPI Number	:	1508885518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHARLES EUGENE AUSTIN L.C.S.W., L.C.D.C.

Provider Business Mailing Address
First Line	:	CMR 402 BOX 1965
Second Line	:
City	:	APO
State	:	RHINELAND PLAZ
Zip	:	09180
Country	:	DE
Telephone Number	:	637-186-1710
Fax Number	:	631-186-6123

Provider Business Practice Location Address
First Line	:	CMR 402
Second Line	:
City	:	APO
State	:	RHINELAND PLAZ
Zip	:	09180
Country	:	DE
Telephone Number	:	637-186-1710
Fax Number	:	637-186-6123

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	09/11/2025

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