# HERSOM PSYCHOTHERAPY, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770216335
- **Authorized official:** MR. JUSTIN I. HERSOM LCSW (OWNER/EMPLOYEE)
- **Authorized official phone:** (832) 326-8552

## Contact information

- **Practice address:** 1301 S CAPITAL OF TEXAS HWY, WEST LAKE HILLS, TX 78746-6574
- **Practice address phone:** (737) 477-9457
- **Mailing address:** 107 NAUTILUS AVE, LAKEWAY, TX 78738-1005
- **Mailing address phone:** (832) 326-8552

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 07/01/2022
- **Last updated:** 08/01/2022