Healthcare Provider Details

I. General information

NPI: 1790402519
Provider Name (Legal Business Name): ANNA HASTINGS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNA KNAPP

II. Dates (important events)

Enumeration Date: 10/24/2022
Last Update Date: 10/24/2022
Certification Date: 10/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

916 S CAPITAL OF TEXAS HWY
WEST LAKE HILLS TX
78746-5210
US

IV. Provider business mailing address

5205 MAULDING PASS
AUSTIN TX
78749-1651
US

V. Phone/Fax

Practice location:
  • Phone: 512-961-5575
  • Fax:
Mailing address:
  • Phone: 737-222-1334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number108358
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: