Provider Demographics
NPI:1801894464
Name:ZENTNER, KATHRYN G (LCSW)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:G
Last Name:ZENTNER
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 1:11605 GUNSMOKE CIR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-2035
Mailing Address - Country:US
Mailing Address - Phone:512-497-2177
Mailing Address - Fax:512-498-0245
Practice Address - Street 1:8701 SHOAL CREEK BLVD
Practice Address - Street 2:SUITE 403
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757-6864
Practice Address - Country:US
Practice Address - Phone:512-497-2177
Practice Address - Fax:512-498-0245
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-08
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23912104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX87439QOtherBCBS
TX172771101Medicaid
TX8E0063Medicare ID - Type Unspecified