Active NPI
Kelly Vanessa Ovalle, LCSW
- Clinical Social Worker
- Cedar Park, TX
National Provider Identifier
1801182472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 50736
- Practice address
- 2217 John Tee Dr
Cedar Park, TX 78613-1753 - Phone
- (314) 494-6530
- NPI assigned
- Jun 22, 2011
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 50736 | TX | Primary |
Addresses
Primary practice location
2217 John Tee Dr
Cedar Park, TX 78613-1753
Mailing address
2217 John Tee Dr
Cedar Park, TX 78613-1753
Phone (314) 494-6530
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50736 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308700800000",
"number": "1801182472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2217 JOHN TEE DR",
"city": "CEDAR PARK",
"state": "TX",
"postal_code": "786131753",
"telephone_number": "314-494-6530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2217 JOHN TEE DR",
"city": "CEDAR PARK",
"state": "TX",
"postal_code": "786131753",
"telephone_number": "314-494-6530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OVALLE",
"first_name": "KELLY",
"middle_name": "VANESSA",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-22",
"last_updated": "2011-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "50736",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cedar Park, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.