Individual provider Active NPI

Mollyanne Vasquez, LCSW

  • Clinical Social Worker
  • West Lake Hills, TX
National Provider Identifier
1922743145
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
104311 Issued in TX
Practice address
3939 Bee Caves Rd Ste A204
West Lake Hills, TX 78746-6429
Phone
(512) 815-3183
NPI assigned
May 2, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

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 104311 TX Primary

Addresses

Primary practice location

3939 Bee Caves Rd Ste A204
West Lake Hills, TX 78746-6429

Mailing address

318 Newberry TRL
San Marcos, TX 78666-8884
Phone (512) 924-7002

Other identifiers 2

IdentifierTypeStateIssuer
104311OtherTXTEXAS STATE BOARD OF SOCIAL WORK EXAMINERS
C017434OtherNCNORTH CAROLINA SOCIAL WORK CERTIFICATION AND LICENSURE BOARD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Nov 14, 2025 through Nov 14, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
104311TXMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1651449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1922743145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 NEWBERRY TRL",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786668884",
            "telephone_number": "512-924-7002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3939 BEE CAVES RD STE A204",
            "city": "WEST LAKE HILLS",
            "state": "TX",
            "postal_code": "787466429",
            "telephone_number": "512-815-3183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASQUEZ",
        "first_name": "MOLLYANNE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-02",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "104311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS STATE BOARD OF SOCIAL WORK EXAMINERS",
            "identifier": "104311",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH CAROLINA SOCIAL WORK CERTIFICATION AND LICENSURE BOARD",
            "identifier": "C017434",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Lake Hills, TX

Sources for this page

Verify at the official NPI Registry.