Provider Demographics
NPI:1760786099
Name:HANEY, KIMBERLY HOOD (LCSW)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:HOOD
Last Name:HANEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5914 FOREST LEDGE ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-3346
Mailing Address - Country:US
Mailing Address - Phone:210-748-0657
Mailing Address - Fax:
Practice Address - Street 1:5914 FOREST LEDGE ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-3346
Practice Address - Country:US
Practice Address - Phone:210-748-0657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-30
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX506291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical