Serendipity Psychotherapy PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

SERENDIPITY PSYCHOTHERAPY PLLC

Practice address

300 S Aw Grimes Blvd Apt 9103
Round Rock, TX 78664-7810

Phone

(833) 554-0942

NPI assigned

Mar 26, 2022

Last updated

Mar 26, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tina Louise Bollman, LCSWNPI 1497206742

Title

Owner

Phone

(512) 468-9881

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tina Louise Bollman, LCSW

  • Clinical Social Worker
  • Round Rock, TX
  • NPI 1497206742
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1648252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648252800000",
    "number": "1265182828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S AW GRIMES BLVD APT 9103",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786647810",
            "telephone_number": "512-468-9881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S AW GRIMES BLVD APT 9103",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786647810",
            "telephone_number": "833-554-0942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENDIPITY PSYCHOTHERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-26",
        "last_updated": "2022-03-26",
        "certification_date": "2022-03-26",
        "status": "A",
        "authorized_official_last_name": "BOLLMAN",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-468-9881",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1748808",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Victoria Marie Seiter, MT-BC
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• Kayla Sellers, FNP-C
• Serenity Care Services Inc
• Serve All Medical Round Rock, PLLC (Clinica Hispana)
• David Servino, PH.D.
• Seton Family of Doctors (Ascension Texas Imaging)
• Seton Family of Hospitals

• Clinical Social Worker in Round Rock, TX
• Providers in Round Rock, 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 Mar 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.