Miranda Keri Velasquez, LMFT, LCDC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

204789 Issued in TX

Practice address

1174 County Road 441
Stockdale, TX 78160-7028

Phone

(830) 344-7396

NPI assigned

Aug 21, 2020

Last updated

Dec 11, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hillhaven Hollow PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Stockdale, TX
  • NPI 1922796879
  Medicare reassignment NPD Authorized official
• Mountain Counseling & Training, Inc.

  • Community Health Clinic/Center
  • Crestline, CA
  • NPI 1164739215
  NPD (past)

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

{
    "created_epoch": "1597968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1942812862",
    "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": {
        "last_name": "VELASQUEZ",
        "first_name": "MIRANDA",
        "middle_name": "KERI",
        "credential": "LMFT, LCDC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-21",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "16215",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "204789",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Kvanvig-Garza, LPC
• Small Town Medical Solutions LLC
• Stockdale Isd
• Stockdale TX SNF Management LLC (Stockdale Residence and Rehabilitation Center)
• Stockdale Volunteer Ambulance Service
• Tiffany Jo Williams, RN
• Wilson County Emergency Services District 3
• Mandy R Wright, FNP
• Sandra Kay Wright, APRN, FNP

• Marriage & Family Therapist in Stockdale, TX
• Providers in Stockdale, TX by specialty
• Marriage & Family Therapist 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; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.