Provider Demographics
NPI:1285946921
Name:QUAGLINO, CHRISTOPHER J (LCSW)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:J
Last Name:QUAGLINO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 W 49TH ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-5640
Mailing Address - Country:US
Mailing Address - Phone:512-775-5940
Mailing Address - Fax:
Practice Address - Street 1:1507 NORTH ST
Practice Address - Street 2:STE 1
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-2656
Practice Address - Country:US
Practice Address - Phone:512-775-5940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-10
Last Update Date:2018-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX509401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical