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NPI Code Detail

MEDICARE: MAUREEN HAVELKA LCSW

MEDICARE:   MAUREEN  HAVELKA  LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker55306TX

General Provider Information

NPI Number : 1457821654
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAUREEN HAVELKA LCSW
Provider Business Mailing Address
First Line : 701 SOUTHCREEK DR
Second Line :
City : ROUND ROCK
State : TX
Zip : 78664-7152
Country : US
Telephone Number : 216-269-1014
Fax Number :
Provider Business Practice Location Address
First Line : 4005 SPICEWOOD SPRINGS RD STE B401
Second Line :
City : AUSTIN
State : TX
Zip : 78759-8680
Country : US
Telephone Number : 512-548-8277
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2018
Last Update Date : 11/29/2018

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Directions to “ MAUREEN HAVELKA LCSW” Practice Location

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