DataLabs

datalabs.health made in the usa

Contact us Sign in | Documentation |

divider

Medicare/Medicaid Verification Programs divider

divider

Medicare Verification Program divider

divider

1730135864

NPI Code Detail

MEDICARE: BLUEBONNET TRAILS COMMUNITY MHMR CENTER

MEDICARE: BLUEBONNET TRAILS COMMUNITY MHMR CENTER

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	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	207Q00000X	Family Medicine Physician
3	2084P0800X	Psychiatry Physician
4	101YM0800X	Mental Health Counselor
5	101YP2500X	Professional Counselor
6	103T00000X	Psychologist
7	103TB0200X	Cognitive & Behavioral Psychologist
8	103TC0700X	Clinical Psychologist
9	103TC2200X	Clinical Child & Adolescent Psychologist
10	103TM1800X	Intellectual & Developmental Disabilities Psychologist
11	103TR0400X	Rehabilitation Psychologist
12	104100000X	Social Worker
13	1041C0700X	Clinical Social Worker
14	106H00000X	Marriage & Family Therapist
15	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730135864
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLUEBONNET TRAILS COMMUNITY MHMR CENTER

Provider Business Mailing Address
First Line	:	1009 N GEORGETOWN ST
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78664-3289
Country	:	US
Telephone Number	:	512-255-1720
Fax Number	:	512-244-8371

Provider Business Practice Location Address
First Line	:	1009 N GEORGETOWN ST
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78664-3289
Country	:	US
Telephone Number	:	512-255-1720
Fax Number	:	512-244-8371

Authorized Official
Title or Position	:	MANAGER
Name	:	MS. AMY BODKINS
Credential	:
Telephone Number	:	512-244-8374

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	08/28/2023

Similar Medicare Providers

1982550547 — LIZVETT GARZA LCSW
Practice Location Address:

1009 N GEORGETOWN ST
ROUND ROCK, TX
78664-3289

Practice Phone: 512-255-1720
Practice Fax:

1447237078 — DAVID WILLIAM COGHE MD
Practice Location Address:

1009 N GEORGETOWN ST
ROUND ROCK, TX
78664-3289

Practice Phone: 512-244-8489
Practice Fax:

1285677559 — MS. MAITREYEE PATEL LUND MD
Practice Location Address:

1009 N GEORGETOWN ST
ROUND ROCK, TX
78664-3289

Practice Phone: 512-244-8374
Practice Fax: 512-244-8371

1710913520 — MR. RICHARD WAYNE MOCZYGEMBA MD
Practice Location Address:

1009 N GEORGETOWN ST
ROUND ROCK, TX
78664-3289

Practice Phone: 512-244-8374
Practice Fax: 512-244-8371

1275569626 — MR. CARL KOONCE CROWTHER MS, LPC
Practice Location Address:

1009 N GEORGETOWN ST
ROUND ROCK, TX
78664-3289

Practice Phone: 512-244-8374
Practice Fax: 512-244-8371

1285660647 — MS. JULIE LYNN MOWAD MS, SLP
Practice Location Address:

1009 N GEORGETOWN ST
ROUND ROCK, TX
78664-3289

Practice Phone: 512-244-8374
Practice Fax: 512-244-8371

Directions to “BLUEBONNET TRAILS COMMUNITY MHMR CENTER ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.