Provider Demographics
NPI:1093389645
Name:HARMACEK, THERESE (LCSW)
Entity type:Individual
Prefix:
First Name:THERESE
Middle Name:
Last Name:HARMACEK
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 1:1203 W CREEK LOOP
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-5623
Mailing Address - Country:US
Mailing Address - Phone:512-672-9071
Mailing Address - Fax:
Practice Address - Street 1:600 ROUND ROCK WEST DR STE 606
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-5005
Practice Address - Country:US
Practice Address - Phone:512-672-9071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-18
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical