Provider Demographics
NPI:1982062816
Name:HILL COUNTRY OCD TREATMENT CENTER
Entity Type:Organization
Organization Name:HILL COUNTRY OCD TREATMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BRAY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:512-636-0104
Mailing Address - Street 1:3355 BEE CAVES RD
Mailing Address - Street 2:SUITE 508
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-6775
Mailing Address - Country:US
Mailing Address - Phone:512-636-0104
Mailing Address - Fax:
Practice Address - Street 1:3000 JOE DIMAGGIO BLVD
Practice Address - Street 2:SUITE 66
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665-3922
Practice Address - Country:US
Practice Address - Phone:512-636-0104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-06
Last Update Date:2016-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36270103TB0200X
TX545391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty