Individual provider Active NPI

Mary Kathryn Owen, LCSW

  • Clinical Social Worker
  • Austin, TX
National Provider Identifier
1558442491
Registry record updated Feb 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
32256 Issued in TX
Practice address
1433 Fairfield Dr
Hill Country Counseling
Austin, TX 78758-7244
Phone
(512) 491-8444
Fax
(512) 491-0226
NPI assigned
Oct 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 32256 TX Primary

Addresses

Primary practice location

1433 Fairfield Dr
Hill Country Counseling
Austin, TX 78758-7244

Mailing address

1433 Fairfield Dr
Austin, TX 78758-7244
Phone (512) 491-8444

Other identifiers 1

IdentifierTypeStateIssuer
142064802MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151215000086 TX Practitioner - Clinical Social Worker 8921309014 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Deep Eddy Psychotherapy Management, LLCGroup PAC ID 2264886936, 70 clinicians

Practice addresses (Care Compare)

1 Chisholm Trail Rd
Suite 225
Round Rock, TX 78681-5106
Phone (512) 956-6463

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
32256TXMDClinical Social Worker
35526TXMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Deep Eddy Psychotherapy Management, LLC CurrentSince Apr 16, 2024 Accepting new patients
Laura McDowell-Salcedo, LCSW, Inc. Clinical PastSince Jan 2, 2002 Accepting new patients
Deep Centered Psychiatry PLLC PastSince Apr 16, 2024 Accepting new patients

Locations

508 Deep Eddy Ave
Austin, TX 78703
Phone (512) 469-0889

1 Chisholm Trail Rd
Ste 225
Round Rock, TX 78681
Phone (512) 547-3610

1922 Dry Creek Way
Ste 108
San Antonio, TX 78259
Phone (512) 887-3993

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518393600000",
    "number": "1558442491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1433 FAIRFIELD DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787587244",
            "telephone_number": "512-491-8444",
            "fax_number": "512-491-0226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1433 FAIRFIELD DR",
            "address_2": "HILL COUNTRY COUNSELING",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787587244",
            "telephone_number": "512-491-8444",
            "fax_number": "512-491-0226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWEN",
        "first_name": "MARY",
        "middle_name": "KATHRYN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2018-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "32256",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142064802",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.