Provider Demographics
NPI:1912410747
Name:HARTIN, AMY ROWAN (LPC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:ROWAN
Last Name:HARTIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 301809
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78703-0031
Mailing Address - Country:US
Mailing Address - Phone:512-669-5450
Mailing Address - Fax:
Practice Address - Street 1:6633 E HWY 290 STE 212
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-1111
Practice Address - Country:US
Practice Address - Phone:512-669-5450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-15
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73181101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional