Provider Demographics
NPI:1699247098
Name:HARTMANN, KATHERINE (PHD, LP, LSSP, NCSP)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:HARTMANN
Suffix:
Gender:F
Credentials:PHD, LP, LSSP, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3007 N LAMAR BLVD STE 209
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-2025
Mailing Address - Country:US
Mailing Address - Phone:512-910-5363
Mailing Address - Fax:
Practice Address - Street 1:3007 N LAMAR BLVD STE 209
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-2025
Practice Address - Country:US
Practice Address - Phone:512-910-5363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-23
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70251103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool