Provider Demographics
NPI:1720827181
Name:HACKFELD, LATRICIA (LPC)
Entity type:Individual
Prefix:
First Name:LATRICIA
Middle Name:
Last Name:HACKFELD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:TRICIA
Other - Middle Name:
Other - Last Name:HACKFELD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:920 SQUAW CREEK RD
Mailing Address - Street 2:
Mailing Address - City:WILLOW PARK
Mailing Address - State:TX
Mailing Address - Zip Code:76087-8256
Mailing Address - Country:US
Mailing Address - Phone:817-223-2685
Mailing Address - Fax:
Practice Address - Street 1:920 SQUAW CREEK RD
Practice Address - Street 2:
Practice Address - City:WILLOW PARK
Practice Address - State:TX
Practice Address - Zip Code:76087-8256
Practice Address - Country:US
Practice Address - Phone:817-223-2685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-23
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX90208101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional