Hillhaven Hollow PLLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

HILLHAVEN HOLLOW PLLC

Practice address

1174 County Road 441
Stockdale, TX 78160-7028

Phone

(830) 344-7396

NPI assigned

Apr 28, 2023

Last updated

Dec 11, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Miranda Keri VelasquezNPI 1942812862

Title

Owner/Provider

Phone

(830) 344-7396

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Miranda Keri Velasquez, LMFT, LCDC

  • Marriage & Family Therapist
  • Stockdale, TX
  • NPI 1942812862
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1682640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733875200000",
    "number": "1922796879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1174 COUNTY ROAD 441",
            "city": "STOCKDALE",
            "state": "TX",
            "postal_code": "781607028",
            "telephone_number": "830-344-7396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1174 COUNTY ROAD 441",
            "city": "STOCKDALE",
            "state": "TX",
            "postal_code": "781607028",
            "telephone_number": "830-344-7396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HILLHAVEN HOLLOW PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-28",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A",
        "authorized_official_last_name": "VELASQUEZ",
        "authorized_official_first_name": "MIRANDA",
        "authorized_official_middle_name": "KERI",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "830-344-7396"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Scott Dukas, MPAS, P.A.-C
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• Alice Finegan, NP
• Elizebeth Foreman
• Emma Gawlik
• Cecelia A Kothmann, FNP
• Tara Kvanvig-Garza, LPC
• Small Town Medical Solutions LLC
• Stockdale Isd
• Stockdale TX SNF Management LLC (Stockdale Residence and Rehabilitation Center)

• Mental Health Clinic/Center (Including Community Mental Health Center) in Stockdale, TX
• Providers in Stockdale, TX by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; 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.