Provider Demographics
NPI:1083260137
Name:ORTEGA-HART, ROXANA (LCSW-S)
Entity Type:Individual
Prefix:
First Name:ROXANA
Middle Name:
Last Name:ORTEGA-HART
Suffix:
Gender:F
Credentials:LCSW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8941 VIGEN CIR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-1601
Mailing Address - Country:US
Mailing Address - Phone:512-577-7045
Mailing Address - Fax:
Practice Address - Street 1:8941 VIGEN CIR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-1601
Practice Address - Country:US
Practice Address - Phone:512-593-2620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-14
Last Update Date:2022-06-01
Deactivation Date:2020-01-24
Deactivation Code:
Reactivation Date:2021-10-20
Provider Licenses
StateLicense IDTaxonomies
TX509301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical