Provider Demographics
NPI:1972055234
Name:MIURA, JODA KAY (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JODA
Middle Name:KAY
Last Name:MIURA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:JODA
Other - Middle Name:KAY
Other - Last Name:HISLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW, LCSW
Mailing Address - Street 1:4820 MORESE PLACE TRAIL
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665
Mailing Address - Country:US
Mailing Address - Phone:859-519-0395
Mailing Address - Fax:
Practice Address - Street 1:1001 CYPRESS CREEK ROAD
Practice Address - Street 2:SUITE 403
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613
Practice Address - Country:US
Practice Address - Phone:513-323-6994
Practice Address - Fax:512-323-9490
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-02
Last Update Date:2025-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1120851041C0700X
TN79341041C0700X
TN111121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical