Provider Demographics
NPI:1053970004
Name:TURBIVILLE, PATRICK (LCSW)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:TURBIVILLE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5003 WALZEM RD STE 745
Mailing Address - Street 2:
Mailing Address - City:WINDCREST
Mailing Address - State:TX
Mailing Address - Zip Code:78218-2118
Mailing Address - Country:US
Mailing Address - Phone:512-806-0137
Mailing Address - Fax:
Practice Address - Street 1:4131 SPICEWOOD SPRINGS RD STE K6
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8600
Practice Address - Country:US
Practice Address - Phone:512-806-0137
Practice Address - Fax:512-842-7256
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-12
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX625301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical