Provider Demographics
NPI:1720796287
Name:HASSELL, PAUL ISAAC (LMSW)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:ISAAC
Last Name:HASSELL
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9417 SINGING QUAIL DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-6134
Mailing Address - Country:US
Mailing Address - Phone:737-308-5965
Mailing Address - Fax:
Practice Address - Street 1:555 ROUND ROCK WEST DR STE E201
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-5052
Practice Address - Country:US
Practice Address - Phone:512-284-7077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105169104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker