Provider Demographics
NPI:1023159084
Name:BYINGTON, GERALD L (LCSW)
Entity type:Individual
Prefix:MR
First Name:GERALD
Middle Name:L
Last Name:BYINGTON
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:PO BOX 164274
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78716-4274
Mailing Address - Country:US
Mailing Address - Phone:512-328-0819
Mailing Address - Fax:512-328-0139
Practice Address - Street 1:1916A HOLLY HILL DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-7647
Practice Address - Country:US
Practice Address - Phone:512-328-0819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical