Active NPI
Mary Gillock, MA
- Mental Health Counselor
- Round Rock, TX
National Provider Identifier
1558047415
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 91905
- Practice address
- 1101 Satellite View Unit 603
Round Rock, TX 78665 - Phone
- (512) 993-9225
- NPI assigned
- Jun 26, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 91905 | TX | Primary |
Addresses
Primary practice location
1101 Satellite View Unit 603
Round Rock, TX 78665
Mailing address
1101 Satellite View Unit 603
Round Rock, TX 78665
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 91905 | TX | MD | Mental Health Counselor |
Interoperability endpoints
- therapyunlocked.marygillock@155920.advancedmd-direct.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687737600000",
"number": "1558047415",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1101 SATELLITE VIEW UNIT 603",
"city": "ROUND ROCK",
"state": "TX",
"postal_code": "78665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 SATELLITE VIEW UNIT 603",
"city": "ROUND ROCK",
"state": "TX",
"postal_code": "78665",
"telephone_number": "512-993-9225"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLOCK",
"first_name": "MARY",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-26",
"last_updated": "2023-06-26",
"certification_date": "2023-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "91905",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Round Rock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.