Individual provider Active NPI

Mary Amanda Jelinek, PSY.D.

  • Psychologist
  • West Lake Hills, TX
National Provider Identifier
1609005628
Registry record updated Dec 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
34920 Issued in TX
Practice address
5524 Bee Caves Rd Ste H2
West Lake Hills, TX 78746-5246
Phone
(512) 710-0551
Fax
(512) 717-6337
NPI assigned
Jul 12, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X 34920 TX Primary

Addresses

Primary practice location

5524 Bee Caves Rd Ste H2
West Lake Hills, TX 78746-5246

Mailing address

PO Box 3041
Marble Falls, TX 78654-3077
Phone (512) 710-0551

Other practice location 1

4749 Williams Dr Ste 301
Georgetown, TX 78633-3711
Phone (512) 710-0551

Other identifiers 2

IdentifierTypeStateIssuer
293738502MedicaidTX
293738503MedicaidTX

Other names 1

  • Dr. Amanda Johnson Professional name

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
I20111116000490 TX Practitioner - Clinical Psychologist 1254505837 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Three Oaks Counseling Group LLCGroup PAC ID 2163728692, 29 clinicians

Practice addresses (Care Compare)

5524 Bee Caves Rd
Suite H2
West Lake Hills, TX 78746-5246
Phone (512) 710-0551

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34920TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Three Oaks Counseling Group, LLC Psychologist CurrentSince Aug 15, 2017 Accepting new patients

Locations

4749 Williams Dr
Ste 301
Georgetown, TX 78633
Phone (512) 710-0551

5524 Bee Caves Rd
Ste H2
West Lake Hills, TX 78746
Phone (512) 649-3050

5524 Bee Caves Rd
Ste K4
West Lake Hills, TX 78746
Phone (512) 649-3050

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1247356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766966400000",
    "number": "1609005628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3041",
            "city": "MARBLE FALLS",
            "state": "TX",
            "postal_code": "786543077",
            "telephone_number": "512-710-0551",
            "fax_number": "512-717-6337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5524 BEE CAVES RD STE H2",
            "city": "WEST LAKE HILLS",
            "state": "TX",
            "postal_code": "787465246",
            "telephone_number": "512-710-0551",
            "fax_number": "512-717-6337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4749 Williams Dr Ste 301",
            "address_purpose": "LOCATION",
            "city": "Georgetown",
            "state": "TX",
            "postal_code": "786333711",
            "country_code": "US",
            "telephone_number": "512-710-0551",
            "fax_number": "512-717-6337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JELINEK",
        "first_name": "MARY",
        "middle_name": "AMANDA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-12",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "TX",
            "license": "34920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "293738502",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "293738503",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "JOHNSON",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in West Lake Hills, TX

Sources for this page

Verify at the official NPI Registry.