Provider Demographics
NPI:1356891592
Name:SIROCCHI, VINCENT DOMINICK III (LCSW)
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:DOMINICK
Last Name:SIROCCHI
Suffix:III
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6404 ALBANY SLEIGH DR
Mailing Address - Street 2:
Mailing Address - City:DEL VALLE
Mailing Address - State:TX
Mailing Address - Zip Code:78617-2047
Mailing Address - Country:US
Mailing Address - Phone:262-914-8245
Mailing Address - Fax:
Practice Address - Street 1:6937 N INTERSTATE 35
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78752-3295
Practice Address - Country:US
Practice Address - Phone:512-445-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-12
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX661441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical