Individual provider Active NPI

Sarah Distefano, LCSW

  • Clinical Social Worker
  • Katy, TX
National Provider Identifier
1073374278
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
57429 Issued in TX
Practice address
21230 Kingsland Blvd Ste 300
Katy, TX 77450-6130
Phone
(281) 984-3494
NPI assigned
Jan 16, 2024
Last updated
Jan 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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 57429 TX Primary

Addresses

Primary practice location

21230 Kingsland Blvd Ste 300
Katy, TX 77450-6130

Mailing address

14403 Bush Sage Dr
Cypress, TX 77429-8358
Phone (832) 623-0217

Other names 1

  • Sarah Ball Former name

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
I20240320001367 TX Practitioner - Clinical Social Worker 5294172722 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Muro Mental Health, PLLC CurrentSince Mar 1, 2024 Accepting new patients

Locations

21230 Kingsland Blvd
Ste 300
Katy, TX 77450
Phone (281) 984-3494

25145 Star Ln
Ste 303
Katy, TX 77494
Phone (281) 868-8900

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1705363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1073374278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14403 BUSH SAGE DR",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774298358",
            "telephone_number": "832-623-0217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21230 KINGSLAND BLVD STE 300",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774506130",
            "telephone_number": "281-984-3494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISTEFANO",
        "first_name": "SARAH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-16",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "57429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARAH",
            "last_name": "BALL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Katy, TX

Sources for this page

Verify at the official NPI Registry.