| Serendipity Psychotherapy Pllc | |
|
300 S Aw Grimes Blvd Apt 9103 Round Rock TX 78664-7810 | |
| (833) 554-0942 | |
| Not Available |
| Full Name | Serendipity Psychotherapy Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 300 S Aw Grimes Blvd Apt 9103, Round Rock, Texas |
| Authorized Official Name and Position | Tina Louise Bollman (OWNER) |
| Authorized Official Contact | 5124689881 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Serendipity Psychotherapy Pllc 300 S Aw Grimes Blvd Apt 9103 Round Rock TX 78664-7810 Ph: (512) 468-9881 | Serendipity Psychotherapy Pllc 300 S Aw Grimes Blvd Apt 9103 Round Rock TX 78664-7810 Ph: (833) 554-0942 |
| NPI Number | 1265182828 |
|---|---|
| Provider Enumeration Date | 03/26/2022 |
| Last Update Date | 03/26/2022 |
| Certification Date | 03/26/2022 |
| Medicare PECOS PAC ID | 6103209101 |
|---|---|
| Medicare Enrollment ID | O20220823003042 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265182828 | NPI | - | NPPES |
| 1748808 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Tina Louise Bollman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497206742 PECOS PAC ID: 8729351762 Enrollment ID: I20170913001678 |
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