Healthcare Provider Details

I. General information

NPI: 1538455050
Provider Name (Legal Business Name): KATHARINE HAMMAN LPC, LCDC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2011
Last Update Date: 06/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12335 HYMEADOW DR SUITE 300
AUSTIN TX
78750-1934
US

IV. Provider business mailing address

12335 HYMEADOW DR SUITE 300
AUSTIN TX
78750-1934
US

V. Phone/Fax

Practice location:
  • Phone: 512-250-9355
  • Fax: 512-250-0229
Mailing address:
  • Phone: 512-250-9355
  • Fax: 512-250-0229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number9654
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number60346
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: