Organization Active NPI

Earle

  • Clinical Social Worker
  • Austin, TX
National Provider Identifier
1518330554
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
EARLE
Doing business as
C. JASON EARLE, LCSW
Practice address
4100 Avenue D
Austin, TX 78751
Phone
(855) 553-2783
Fax
(855) 553-2783
NPI assigned
Nov 12, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Charles Jason Earle, LCSWNPI 1295173672
Title
Director
Phone
(855) 553-2783

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

Primary practice location

4100 Avenue D
Austin, TX 78751

Mailing address

1101 W 34TH St Ste 256
Austin, TX 78705-1907
Phone (855) 553-2753

Other names 1

  • C. JASON EARLE, LCSW Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151228001487 TX Part B Supplier - Clinic/Group Practice 1254632755 Receives reassigned benefits from 1 practitioner
Practice locations: Austin, TX

National Provider Directory

National Provider Directory

Locations

7703 N Lamar Blvd
Ste 225
Austin, TX 78752
Phone (855) 527-8728

6901 N Lamar Blvd
Ste 124
Austin, TX 78752
Phone (855) 527-8728

6901 N Lamar Blvd
Austin, TX 78752
Phone (512) 939-5396

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1447286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737504000000",
    "number": "1518330554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 W 34TH ST STE 256",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787051907",
            "telephone_number": "855-553-2753",
            "fax_number": "855-553-2753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 AVENUE D",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78751",
            "telephone_number": "855-553-2783",
            "fax_number": "855-553-2783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EARLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-12",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-10",
        "status": "A",
        "authorized_official_last_name": "EARLE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "JASON",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "855-553-2783",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "C. JASON EARLE, LCSW",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "C. JASON EARLE, LCSW",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.