Provider Demographics
NPI:1124577655
Name:KASKOW, CHRISTINE (LPC INTERN)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:KASKOW
Suffix:
Gender:F
Credentials:LPC INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 E ANDERSON LN
Mailing Address - Street 2:SUITE 120
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78752-1236
Mailing Address - Country:US
Mailing Address - Phone:512-961-5575
Mailing Address - Fax:
Practice Address - Street 1:313 E ANDERSON LN
Practice Address - Street 2:SUITE 120
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78752-1236
Practice Address - Country:US
Practice Address - Phone:512-961-5575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-26
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75484101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional