Individual provider Active NPI

Wendy McDonald, LCSW

  • Clinical Social Worker
  • Bryan, TX
National Provider Identifier
1043315237
Registry record updated Jun 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
32609 Issued in TX
Practice address
207 Sulphur Springs Rd
Bryan, TX 77801-3134
Phone
(979) 846-8600
Fax
(866) 214-0222
NPI assigned
Sep 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 32609 TX Primary

Addresses

Primary practice location

207 Sulphur Springs Rd
Bryan, TX 77801-3134

Mailing address

207 Sulphur Springs Rd
Bryan, TX 77801-3134
Phone (979) 846-8600

Other identifiers 2

IdentifierTypeStateIssuer
0081JMOtherTXBLUE CROSS BLUE SHIELD
154728301MedicaidTX

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
I20041022000793 TX Practitioner - Clinical Social Worker 5092776096 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

207 Sulphur Springs Rd
Bryan, TX 77801-3134
Phone (979) 218-0689

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wendy McDonald PC Clinical Current Accepting new patients
Wendy McDonald PC Clinical CurrentSince Nov 30, 2013 Accepting new patients
Brazos Valley Mental Health and Wellness, LLC Past Accepting new patients

Locations

207 Sulphur Springs Rd
Bryan, TX 77801
Phone (979) 823-8101

117 Royal St
Bryan, TX 77801
Phone (979) 777-1683

115 Royal St
Bryan, TX 77801
Phone (936) 222-3952

Organizations & group practices 3

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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466985600000",
    "number": "1043315237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 SULPHUR SPRINGS RD",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778013134",
            "telephone_number": "979-846-8600",
            "fax_number": "866-214-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 SULPHUR SPRINGS RD",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778013134",
            "telephone_number": "979-846-8600",
            "fax_number": "866-214-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "WENDY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2016-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "32609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0081JM",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154728301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

Verify at the official NPI Registry.