Provider Demographics
NPI:1376311266
Name:POOLER, DAVID KENNETH (LCSW-S)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:KENNETH
Last Name:POOLER
Suffix:
Gender:M
Credentials:LCSW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9913 BURGUNDY LN
Mailing Address - Street 2:
Mailing Address - City:WOODWAY
Mailing Address - State:TX
Mailing Address - Zip Code:76712-3101
Mailing Address - Country:US
Mailing Address - Phone:254-722-9633
Mailing Address - Fax:
Practice Address - Street 1:9913 BURGUNDY LN
Practice Address - Street 2:
Practice Address - City:WOODWAY
Practice Address - State:TX
Practice Address - Zip Code:76712-3101
Practice Address - Country:US
Practice Address - Phone:254-722-9633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX581911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical