Provider Demographics
NPI:1780825448
Name:HADEN, MARION (LCSW)
Entity Type:Individual
Prefix:
First Name:MARION
Middle Name:
Last Name:HADEN
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 1:2501 W WILLIAM CANNON DR
Mailing Address - Street 2:SUITE 401
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-5281
Mailing Address - Country:US
Mailing Address - Phone:512-416-7246
Mailing Address - Fax:512-416-6791
Practice Address - Street 1:2501 W WILLIAM CANNON DR
Practice Address - Street 2:SUITE 401
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-5281
Practice Address - Country:US
Practice Address - Phone:512-416-7246
Practice Address - Fax:512-416-6791
Is Sole Proprietor?:No
Enumeration Date:2009-03-10
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX240371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX201429201Medicaid
TX88102QOtherBCBS ID
8L9494Medicare PIN