Provider Demographics
NPI:1114299302
Name:LESCAULT, DORINDA LINN (LCSW)
Entity Type:Individual
Prefix:
First Name:DORINDA
Middle Name:LINN
Last Name:LESCAULT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DORINDA
Other - Middle Name:LINN
Other - Last Name:GATLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20912 OAK RDG
Mailing Address - Street 2:
Mailing Address - City:LAGO VISTA
Mailing Address - State:TX
Mailing Address - Zip Code:78645-6057
Mailing Address - Country:US
Mailing Address - Phone:210-710-4303
Mailing Address - Fax:
Practice Address - Street 1:3000 POLAR LN STE 101
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-3065
Practice Address - Country:US
Practice Address - Phone:844-824-8775
Practice Address - Fax:281-648-2200
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-02
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX55068104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker