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NPI Code Detail

MEDICARE: MAUREEN HAVELKA LCSW PLLC

MEDICARE: MAUREEN HAVELKA LCSW PLLC
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 Worker

General Provider Information

NPI Number : 1639643695
Entity Type Code : Organization
Provider Name (Legal Business Name) : MAUREEN HAVELKA LCSW PLLC
Provider Business Mailing Address
First Line : 4005 SPICEWOOD SPRINGS RD STE B401
Second Line :
City : AUSTIN
State : TX
Zip : 78759-8680
Country : US
Telephone Number :
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 : MANAGING MEMBER
Name : MAUREEN HAVELKA
Credential : LCSW
Telephone Number : 512-548-8277
Provider Enumeration Date : 01/14/2019
Last Update Date : 01/14/2019

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