Organization
HERSOM PSYCHOTHERAPY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUSTIN I. HERSOM LCSW (OWNER/EMPLOYEE)
(832) 326-8552
Entity
Organization
Contact information
Practice address
1301 S CAPITAL OF TEXAS HWY, WEST LAKE HILLS, TX 78746-6574
(737) 477-9457
Mailing address
107 NAUTILUS AVE, LAKEWAY, TX 78738-1005
(832) 326-8552
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
07/01/2022
Last updated
08/01/2022
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