Kelly Manuel Bastrop Counseling, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

KELLY MANUEL BASTROP COUNSELING, PLLC

Practice address

111 N Hasler Blvd Ste 219
Bastrop, TX 78602-3984

Phone

(512) 985-7104

NPI assigned

Jan 5, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Kelly A Manuel, LCSW, LCDCNPI 1396401212

Title

Governing Authority

Phone

(512) 985-7104

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kelly Manuel, LCSW

  • Clinical Social Worker
  • Bastrop, TX
  • NPI 1396401212
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1641340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641600000000",
    "number": "1033870662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "157 LISA LN UNIT B",
            "city": "BASTROP",
            "state": "TX",
            "postal_code": "786025782",
            "telephone_number": "512-985-7104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N HASLER BLVD STE 219",
            "city": "BASTROP",
            "state": "TX",
            "postal_code": "786023984",
            "telephone_number": "512-985-7104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY MANUEL BASTROP COUNSELING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-05",
        "last_updated": "2022-01-08",
        "certification_date": "2022-01-08",
        "status": "A",
        "authorized_official_last_name": "MANUEL",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "GOVERNING AUTHORITY",
        "authorized_official_telephone_number": "512-985-7104",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW, LCDC"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://headway.com",
            "affiliation": "N",
            "address_1": "114 5th Ave Fl 2",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100115611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Keisha Meashall Jones, RDH
• Journey of Courage LLC
• Tracie Poe Kadura, R.PH.
• Deepa P Karunakaran, FNP
• Marisol Keahey, LCSW
• Bonnie Jean Kemnitz, DVM
• Jihong Kim, NP
• Alisa Kirklin
• Sheryl Ann Kosler, PHARMD
• Sarah Kowalski

• Clinical Social Worker in Bastrop, TX
• Providers in Bastrop, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.