Provider Demographics
NPI:1427321009
Name:HANEY, KATIE ELIZABETH (LCSW)
Entity type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:ELIZABETH
Last Name:HANEY
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 1:1222 N MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-5712
Mailing Address - Country:US
Mailing Address - Phone:210-212-2323
Mailing Address - Fax:210-271-9414
Practice Address - Street 1:1222 N MAIN AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-5712
Practice Address - Country:US
Practice Address - Phone:210-212-2323
Practice Address - Fax:210-271-9414
Is Sole Proprietor?:No
Enumeration Date:2012-02-13
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX500241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical