Provider Demographics
NPI:1285414581
Name:HARGROVE, CAITLIN (LPC-A)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:HARGROVE
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11250 TAYLOR DRAPER LN APT 832
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-3978
Mailing Address - Country:US
Mailing Address - Phone:603-484-1809
Mailing Address - Fax:
Practice Address - Street 1:2525 WALLINGWOOD DR STE 301
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-6922
Practice Address - Country:US
Practice Address - Phone:512-815-2305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-03
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX92350101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health