Provider Demographics
NPI:1285696088
Name:HALL, KATHLEEN A (LCSW)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:A
Last Name:HALL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:A
Other - Last Name:STRAHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10607 DOUBLE SPUR LOOP
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-6915
Mailing Address - Country:US
Mailing Address - Phone:512-297-1102
Mailing Address - Fax:866-300-4481
Practice Address - Street 1:13706 RESEARCH BLVD
Practice Address - Street 2:STE 211
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-1839
Practice Address - Country:US
Practice Address - Phone:512-297-1102
Practice Address - Fax:866-300-4481
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX325731041C0700X
TX32537101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX203846088OtherTAX IDENTIFICATION NUMBER