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ROXANE VAN DER LELIE MFT-A
NPI 1851153498
Marriage & Family Therapist in Austin, TX

Active since January 29, 2024PECOS Enrolled
1206 W 43RD ST, AUSTIN, TX 78756(512) 710-7645 Get Directions Write a Review

NPPES record last updated: January 29, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Roxane Van Der Lelie Mft-a NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ROXANE VAN DER LELIE MFT-A (NPI 1851153498) is an individual marriage & family therapist in Austin, Texas, licensed in Texas (205075) and active in the NPI registry since January 2024. She is enrolled in Medicare PECOS, maintains a secondary practice location in Austin, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1851153498
Entity TypeIndividualFemale
Primary Taxonomy106H00000X
Provider Legal NameROXANE VAN DER LELIECredential: MFT-A
Location Address1206 W 43RD STAustin, TX 78756-3302
Mailing Address1101 Eason StAustin, TX 78703-4822 · (631) 943-6593
Phone(512) 710-7645
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateJanuary 29, 2024
NPPES CertifiedJanuary 29, 2024
✔ NPI 1851153498 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers
Taxonomy Code106H00000X
License✔ Licensed in TX · 205075
Definition
A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.
1206 W 43RD ST, Austin, TX 78756
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Secondary Practice Location 1

Location 11205 W 43rd StAustin, TX 78756-3301 · Phone (512) 710-7645

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Roxane Van Der Lelie Mft-a is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5395210215
PECOS Enrollment IDI20260408002972
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Roxane Van Der Lelie reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Bloom Therapy, PLLC
Same address
Professional
1205 W 43RD ST
Austin, TX 78756
  • Reassigned Medicare billing, Texas enrollment
  • 4 clinicians in this Medicare group
NPI 1649677006 (512) 660-9611

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARIEL SAHAD LPC-A
Counselor (Mental Health)
1206 W 43RD ST
AUSTIN, TX 78756
Travis County (512) 710-7645
JESSICA MCMAHON
Counselor (Professional)
1206 W 43RD ST
AUSTIN, TX 78756
Travis County (512) 522-2810
KAMERON EMERSON MCCLINTIC
Counselor (Mental Health)
1206 W 43RD ST
AUSTIN, TX 78756
Travis County (512) 710-7645

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Roxane Van Der Lelie's NPI number?

The NPI number for Roxane Van Der Lelie is 1851153498. It was assigned to this individual provider in the NPPES registry on January 29, 2024.

Where is Roxane Van Der Lelie located?

Roxane Van Der Lelie practices at 1206 W 43rd St, Austin, TX 78756. The listed phone number is (512) 710-7645.

What is Roxane Van Der Lelie's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Is Roxane Van Der Lelie enrolled in Medicare?

Yes. Roxane Van Der Lelie is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Roxane Van Der Lelie's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Roxane Van Der Lelie reassigns Medicare benefits to Bloom Therapy, PLLC (Austin, TX). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Roxane Van Der Lelie's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Roxane Van Der Lelie was last updated on January 29, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.