Individual provider Active NPI

Kelley Patricia Logans-Ali, LCSW-S

  • Clinical Social Worker
  • San Antonio, TX
National Provider Identifier
1013057058
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
36044 Issued in TX
Practice address
6322 Sovereign St Ste 139
San Antonio, TX 78229-5133
Phone
(210) 386-2993
Fax
(210) 579-7051
NPI assigned
Feb 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 36044 TX
Clinical Social Worker 1041C0700X 36044 TX Primary

Addresses

Primary practice location

6322 Sovereign St Ste 139
San Antonio, TX 78229-5133

Mailing address

6322 Sovereign St Ste 139
San Antonio, TX 78229-5133
Phone (210) 386-2993

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110222000507 TX Practitioner - Clinical Social Worker 9638350861 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6322 Sovereign St
Suite 139
San Antonio, TX 78229-5133
Phone (210) 237-5443

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sistercare LLC Clinical CurrentSince Oct 30, 2018 Accepting new patients

Locations

6322 Sovereign St
Ste 139
San Antonio, TX 78229
Phone (210) 237-5443

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1013057058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6322 SOVEREIGN ST STE 139",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782295133",
            "telephone_number": "210-386-2993",
            "fax_number": "210-579-7051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6322 SOVEREIGN ST STE 139",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782295133",
            "telephone_number": "210-386-2993",
            "fax_number": "210-579-7051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGANS-ALI",
        "first_name": "KELLEY",
        "middle_name": "PATRICIA",
        "credential": "LCSW-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TX",
            "license": "36044",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "36044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.