Provider Demographics
NPI:1518588318
Name:KAST, PHILLIP MURRAY (LPC)
Entity Type:Individual
Prefix:MR
First Name:PHILLIP
Middle Name:MURRAY
Last Name:KAST
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1387
Mailing Address - Street 2:
Mailing Address - City:WIMBERLEY
Mailing Address - State:TX
Mailing Address - Zip Code:78676-1387
Mailing Address - Country:US
Mailing Address - Phone:713-398-4842
Mailing Address - Fax:210-598-0468
Practice Address - Street 1:101 FM 3237 STE C
Practice Address - Street 2:
Practice Address - City:WIMBERLEY
Practice Address - State:TX
Practice Address - Zip Code:78676-5371
Practice Address - Country:US
Practice Address - Phone:713-398-4842
Practice Address - Fax:210-598-0468
Is Sole Proprietor?:No
Enumeration Date:2020-05-03
Last Update Date:2020-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73118101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional