Elisa Marie Gomez de Sobrevilla, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

66015 Issued in TX

Practice address

6609 Blanco Rd Ste 365
San Antonio, TX 78216-6171

Phone

(210) 705-1749

Fax

(210) 610-5256

NPI assigned

Jun 4, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

A New Start Counseling ServicesGroup PAC ID 1951701010, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• A New Start Counseling Services

  • Clinical Social Worker
  • San Antonio, TX
  • NPI 1255937447
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1654300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654300800000",
    "number": "1073252201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6609 BLANCO RD STE 365",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782166171",
            "telephone_number": "210-705-1749",
            "fax_number": "210-610-5256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6609 BLANCO RD STE 365",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782166171",
            "telephone_number": "210-705-1749",
            "fax_number": "210-610-5256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ DE SOBREVILLA",
        "first_name": "ELISA",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-04",
        "last_updated": "2022-06-04",
        "certification_date": "2022-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "66015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Golliher, AU.D.
• Epiphany Golston
• Elias Lefteris Gomatos, DPM
• Brenda Esmeralda Gomes, LSSP
• Miguel Angel Gomez Calderon
• Margo Gomez Hall, MS, LPC
• Isack Vivaldi Gomez Jimenez
• Angela Andrea Gomez Romero, DDS
• Nelson Gomez Torres
• Rocio Gomez-Enriquez

• Clinical Social Worker in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.