Individual provider Active NPI

Roy G. Leitch III, LCSW

  • Clinical Social Worker
  • Cedar Park, TX
National Provider Identifier
1568830024
Registry record updated Nov 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
61347 Issued in TX
Practice address
345 Cypress Creek Rd Ste 102
Cedar Park, TX 78613-4484
Phone
(512) 842-5168
NPI assigned
Sep 14, 2015
Last updated
Nov 18, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 61347 TX
Clinical Social Worker 1041C0700X 61347 TX Primary

Addresses

Primary practice location

345 Cypress Creek Rd Ste 102
Cedar Park, TX 78613-4484

Mailing address

3812 Good Night TRL
Leander, TX 78641-3608
Phone (248) 797-6775

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
I20151104002587 TX Practitioner - Clinical Social Worker 1951611839 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61347TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling LLC Mental Health CurrentSince Aug 24, 2021 Accepting new patients

Locations

345 Cypress Creek Rd
Ste 102
Cedar Park, TX 78613
Phone (512) 649-2270

1000 Post and Paddock St
Ste 102
Grand Prairie, TX 75050

4903 82nd St
Ste 60
Lubbock, TX 79424
Phone (806) 507-6934

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

Organizations & group practices 1

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": "1442188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574035200000",
    "number": "1568830024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3812 GOOD NIGHT TRL",
            "city": "LEANDER",
            "state": "TX",
            "postal_code": "786413608",
            "telephone_number": "248-797-6775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 CYPRESS CREEK RD STE 102",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786134484",
            "telephone_number": "512-842-5168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEITCH",
        "first_name": "ROY",
        "middle_name": "G.",
        "name_suffix": "III",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-14",
        "last_updated": "2019-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "61347",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "61347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Park, TX

Sources for this page

Verify at the official NPI Registry.