Provider Demographics
NPI:1669849790
Name:UMBERGER, TOM (LCSW)
Entity Type:Individual
Prefix:
First Name:TOM
Middle Name:
Last Name:UMBERGER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:THOMAS
Other - Middle Name:CHRISTIAN
Other - Last Name:UMBERGER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:5409 HARVEST LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-3140
Mailing Address - Country:US
Mailing Address - Phone:512-767-8676
Mailing Address - Fax:
Practice Address - Street 1:5409 HARVEST LN
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-3140
Practice Address - Country:US
Practice Address - Phone:512-767-8676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-24
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX533671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical