Organization Active NPI

Kindly Psychotherapy, PLLC

  • Clinical Social Worker
  • Round Rock, TX
National Provider Identifier
1831034537
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
KINDLY PSYCHOTHERAPY, PLLC
Practice address
1101 Satellite VW Unit 603
Round Rock, TX 78665-1592
Phone
(512) 843-1154
Fax
(512) 894-6412
NPI assigned
Apr 21, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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

Authorized official

Name
Samantha Cannon Roberts, LCSWNPI 1699535484
Title
Owner/Therapist
Phone
(512) 843-1154

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

1101 Satellite VW Unit 603
Round Rock, TX 78665-1592

Mailing address

716 Mais Dr
Georgetown, TX 78626-3058
Phone (512) 843-1154

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260529001244 TX Part B Supplier - Clinic/Group Practice 0648740704 Receives reassigned benefits from 1 practitioner
Practice locations: Round Rock, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1776729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776729600000",
    "number": "1831034537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 MAIS DR",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786263058",
            "telephone_number": "512-843-1154",
            "fax_number": "512-894-6412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 SATELLITE VW UNIT 603",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786651592",
            "telephone_number": "512-843-1154",
            "fax_number": "512-894-6412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINDLY PSYCHOTHERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-21",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_middle_name": "CANNON",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "512-843-1154",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "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 Apr 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.