Provider Demographics
NPI:1760299663
Name:HERING, KATHLEEN GRACE (LCSW)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:GRACE
Last Name:HERING
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 1:316 SAN SABA ST
Mailing Address - Street 2:
Mailing Address - City:MEADOWLAKES
Mailing Address - State:TX
Mailing Address - Zip Code:78654-7116
Mailing Address - Country:US
Mailing Address - Phone:214-662-3869
Mailing Address - Fax:
Practice Address - Street 1:3340 STATE HIGHWAY 71 W
Practice Address - Street 2:
Practice Address - City:HORSESHOE BAY
Practice Address - State:TX
Practice Address - Zip Code:78657-9657
Practice Address - Country:US
Practice Address - Phone:830-637-7848
Practice Address - Fax:830-549-4819
Is Sole Proprietor?:No
Enumeration Date:2024-12-13
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1073321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical