MEDICARE: ROCKROSE THERAPEUTIC CENTER, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1255027454
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROCKROSE THERAPEUTIC CENTER, PLLC

Provider Business Mailing Address
First Line	:	7500 MITRA DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78739-1957
Country	:	US
Telephone Number	:	337-789-2111
Fax Number	:

Provider Business Practice Location Address
First Line	:	8500 SHOAL CREEK BLVD STE 114
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78757-7591
Country	:	US
Telephone Number	:	512-593-8510
Fax Number	:

Authorized Official
Title or Position	:	OWNER/THERAPIST
Name	:	ASHLEY STUBBLEFIELD
Credential	:	LCSW-S
Telephone Number	:	512-593-8510

Provider Enumeration Date	:	04/12/2023
Last Update Date	:	12/01/2025

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