Healthcare Provider Details

I. General information

NPI: 1831034537
Provider Name (Legal Business Name): KINDLY PSYCHOTHERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 SATELLITE VW UNIT 603
ROUND ROCK TX
78665-1592
US

IV. Provider business mailing address

716 MAIS DR
GEORGETOWN TX
78626-3058
US

V. Phone/Fax

Practice location:
  • Phone: 512-843-1154
  • Fax: 512-894-6412
Mailing address:
  • Phone: 512-843-1154
  • Fax: 512-894-6412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: SAMANTHA CANNON ROBERTS
Title or Position: OWNER/THERAPIST
Credential: LCSW
Phone: 512-843-1154