DR. MARY AMANDA JELINEK (PSY.D.) – Psychologist, NPI 1609005628

DR. MARY AMANDA JELINEK (PSY.D.) is a healthcare provider. based in Georgetown, Texas. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PSY.D.. They hold a License No. 34920 (TX). The NPI Number for DR. MARY AMANDA JELINEK (PSY.D.) is 1609005628

Main info

Female
Sole Proprietor
19 Years Of Experience
Accepts Medicare Assignment
Name
DR. MARY AMANDA JELINEK (PSY.D.)
NPI
1609005628
Phone
(512) 710-0551
Address
4749 Williams Dr Ste 301
Enumeration Date
12 July 2009
Last Update Date
29 December 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5127100551
Graduation Year
2007 (19 years ago)
PAC ID
1254505837
Group Practice PAC ID
2163728692
Professional Enrollment ID
I20111116000490
Address ID
TX787465246WE5524XRDXX403
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience56
Completeness85
Years active:16State licenses:1Digital endpointsOther names

1,347 CLINICAL PSYCHOLOGIST in TX

Provider Addresses for DR. MARY AMANDA JELINEK (PSY.D.)

  • 4749 Williams Dr Ste 301

    Georgetown, TX 786333711

    Phone: (512) 710-0551

    Fax: (512) 717-6337

    Type: Location

  • PO BOX 3041

    MARBLE FALLS, TX 786543077

    Phone: (512) 710-0551

    Fax: (512) 717-6337

    Type: Mailing

  • 5524 BEE CAVES RD STE H2

    WEST LAKE HILLS, TX 787465246

    Phone: (512) 710-0551

    Fax: (512) 717-6337

    Type: Location

  • 4749, Williams Drive, Georgetown, Williamson County, Texas, 78633, United States

    SUITE 301

    GEORGETOWN, TX 786333710

    Phone: (512) 809-3141

    Fax: (254) 616-9487

    Type: Mailing

  • 5524 BEE CAVES ROAD, SUITE K4

    WEST LAKE HILLS, TX 787467874

    Phone: (512) 710-0551

    Fax: (512) 717-6337

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-11-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20111116000490IClinical PsychologistTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 78633)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2163728692View full group profile
NameSpecialtyState
Nurse PractitionerTX
-TX
Clinical Social WorkerTX
Clinical Social WorkerTX
-TX
Clinical Social WorkerOH
Clinical Social WorkerTX
Mental Health CounselorTX
Mental Health CounselorTX
Clinical Social WorkerTX

Reviews

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Frequently asked questions

Can I verify DR. MARY AMANDA JELINEK (PSY.D.) with an NPI only?
You can start verification with NPI 1609005628 for DR. MARY AMANDA JELINEK (PSY.D.), then check state licensing separately.
Does the file indicate DR. MARY AMANDA JELINEK (PSY.D.) is practicing under active NPI?
Directory data currently reports DR. MARY AMANDA JELINEK (PSY.D.) as active.
What is DR. MARY AMANDA JELINEK (PSY.D.)'s specialty?
The listing groups DR. MARY AMANDA JELINEK (PSY.D.) with Psychologist. Clinical services aligned with this taxonomy classification.
What area does DR. MARY AMANDA JELINEK (PSY.D.) serve?
DR. MARY AMANDA JELINEK (PSY.D.)'s listing highlights Georgetown, Texas; more addresses can appear in NPPES.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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