Kelliana Magallon

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

89110 Issued in TX

Practice address

400 W Main St
Round Rock, TX 78664-5808

Phone

(512) 843-5173

NPI assigned

Mar 13, 2024

Last updated

May 28, 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 2

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

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.

• Deer Oaks Geriatric Services P C

  dba Deer Oaks Consultation Services

  • Clinical Psychologist
  • San Antonio, TX
  • NPI 1134169287
  Medicare reassignment NPD
• Deer Oaks Mental Health Associates PC

  • Clinical Psychologist
  • Las Cruces, NM
  • NPI 1134175763
  NPD (past)

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

{
    "created_epoch": "1710288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1952169930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7924 BASSANO DR",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786652128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W MAIN ST",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786645808",
            "telephone_number": "512-843-5173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGALLON",
        "first_name": "KELLIANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-13",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "89110",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "89110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sherri Madera
• Jennifer Ann Madere, LPC
• Hala Madison, RN
• Maffeo Pediatric Therapy Management, LLC (Kidz Therapeze Round Rock)
• Lynne D. Maffeo, PT
• Cynthia Magana, RBT
• Leilani Melissa Magdaleno, DO
• Willie B Magdamo Jr., M.D
• Emily Griffin Magee, DMD
• Magella Medical Associates Billing, Inc. (Magella Medical Associates)

• Professional Counselor in Round Rock, TX
• Providers in Round Rock, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.