Provider Demographics
NPI:1376342261
Name:BEAULNE-ORTIZ, MADELINE (LCSW)
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:
Last Name:BEAULNE-ORTIZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MADELINE
Other - Middle Name:
Other - Last Name:BEAULNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1508 PARKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-8611
Mailing Address - Country:US
Mailing Address - Phone:214-680-6482
Mailing Address - Fax:
Practice Address - Street 1:921 W NEW HOPE DR STE 504
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-6786
Practice Address - Country:US
Practice Address - Phone:512-688-4303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1045781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical