Mia Roldan Austin Therapy PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MIA ROLDAN AUSTIN THERAPY PLLC

Practice address

4101 Medical Pkwy Ste 109
Austin, TX 78756-3724

Phone

(512) 413-0239

NPI assigned

Feb 8, 2019

Organization subpart

No

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

Authorized official

Name

Anna-Marie Christina Roldan, LCSW, LCDC

Title

Owner

Phone

(512) 413-0239

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1549584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1982169496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6104 SHOAL CREEK BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787573130",
            "telephone_number": "512-413-0239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 MEDICAL PKWY STE 109",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787563724",
            "telephone_number": "512-413-0239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIA ROLDAN AUSTIN THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-08",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "ROLDAN",
        "authorized_official_first_name": "ANNA-MARIE",
        "authorized_official_middle_name": "CHRISTINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-413-0239",
        "authorized_official_credential": "LCSW, LCDC"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 1",
            "identifier": "1790130318",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nosheen Amir Mian, M.D.
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• Michael B. Doughty

• Clinical Social Worker in Austin, TX
• Providers in Austin, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.