Provider Demographics
NPI:1316460223
Name:SUMPTION, PATRICIA MAUREEN (LCSW)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:MAUREEN
Last Name:SUMPTION
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 1:3517 PEREGRINE FALCON DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-7436
Mailing Address - Country:US
Mailing Address - Phone:512-699-1561
Mailing Address - Fax:
Practice Address - Street 1:3102 BEE CAVES RD STE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-5569
Practice Address - Country:US
Practice Address - Phone:512-699-1561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-23
Last Update Date:2017-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX592231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical