Philip Conrad, LCSW

Individual provider Active NPI Clinical Social Worker · The Colony, TX

NPI 1053372979 · NPPES record last updated Dec 2, 2011

Key facts

NPI
1053372979
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
52003 (TX)
Practice address
6115 Saintsbury Drive
No 25
The Colony, TX 75056-5212
Phone
(469) 358-1060
NPI assigned
Mar 30, 2006
Sex
Male
Sole proprietor
Yes

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Assurasource LTD Clinical Past
since Apr 10, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 52003 TX Yes

Addresses

Primary practice location

6115 Saintsbury Drive
No 25
The Colony, TX 75056-5212

Mailing address

6115 Saintsbury Dr
No 25
The Colony, TX 75056-5388
Phone (469) 358-1060

Other providers in The Colony, TX

All providers in The Colony, TX · Clinical Social Worker in Texas

Sources for this page

Verify at the official NPI Registry.