Provider Demographics
NPI:1689811838
Name:HARTSELL, NICTE-HA (M ED, LPC)
Entity Type:Individual
Prefix:
First Name:NICTE-HA
Middle Name:
Last Name:HARTSELL
Suffix:
Gender:F
Credentials:M ED, LPC
Other - Prefix:
Other - First Name:NICTE-HA
Other - Middle Name:
Other - Last Name:VAZQUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6800 PARK TEN BLVD STE 200S
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-4293
Mailing Address - Country:US
Mailing Address - Phone:210-261-1060
Mailing Address - Fax:210-261-1821
Practice Address - Street 1:10975 APPLEWHITE RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78224-3092
Practice Address - Country:US
Practice Address - Phone:210-631-0318
Practice Address - Fax:106-310-3192
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-09
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62685101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional