Provider Demographics
NPI:1588328520
Name:WASSON, ABBY LYNN (LCSW)
Entity type:Individual
Prefix:
First Name:ABBY
Middle Name:LYNN
Last Name:WASSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12218 GRIMSLEY DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-3157
Mailing Address - Country:US
Mailing Address - Phone:972-953-8618
Mailing Address - Fax:
Practice Address - Street 1:12218 GRIMSLEY DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-3157
Practice Address - Country:US
Practice Address - Phone:972-953-8618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX548011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical