Provider Demographics
NPI:1538147699
Name:HAKES, PATRICIA P (LCSW)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:P
Last Name:HAKES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4131 SPICEWOOD SPRINGS RD
Mailing Address - Street 2:BLDG L STE. 4
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8661
Mailing Address - Country:US
Mailing Address - Phone:512-454-0265
Mailing Address - Fax:512-342-1043
Practice Address - Street 1:4131 SPICEWOOD SPRINGS RD
Practice Address - Street 2:BLDG L STE. 4
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8661
Practice Address - Country:US
Practice Address - Phone:512-454-0265
Practice Address - Fax:512-342-1043
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-08
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSW00835104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX004KMOtherBLUE CROSS BLUE SHIEDL
TX1640690-01Medicaid
TX5521672OtherAETNA
TX012408000OtherMAGELLAN BEHAVIORAL HEALT
TX004KMOtherBLUE CROSS BLUE SHIEDL