Individual provider Active NPI

Melanie D Little, LMSW, LCDC

  • Social Worker
  • Canyon Lake, TX
National Provider Identifier
1083188338
Registry record updated Jan 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
66579 Issued in TX
Practice address
26229 N Cranes Mill Rd
Canyon Lake, TX 78133-1957
Phone
(830) 214-1825
NPI assigned
Jan 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 66579 TX Primary

Addresses

Primary practice location

26229 N Cranes Mill Rd
Canyon Lake, TX 78133-1957

Mailing address

26229 N Cranes Mill Rd
Canyon Lake, TX 78133-1957
Phone (210) 833-3804

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
I20210409000256 TX Practitioner - Clinical Social Worker 3870901994 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Counseling4Life, LLCGroup PAC ID 5496163511, 15 clinicians

Practice addresses (Care Compare)

17206 Blanco Rd
BLDG 2
San Antonio, TX 78232-2816
Phone (210) 209-0642

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
66579TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Stephanie a Richards LPC, PLLC CurrentSince Mar 12, 2024 Accepting new patients
Counseling4Life, LLC CurrentSince Mar 18, 2021 Accepting new patients
Goodmindrx PastSince Aug 4, 2024 Accepting new patients

Locations

17206 Blanco Rd
Bldg 2
San Antonio, TX 78232
Phone (210) 209-0642

16607 Blanco Rd
Ste 1404
San Antonio, TX 78232
Phone (210) 209-0642

17206 Blanco Rd
Ste 2101
San Antonio, TX 78232
Phone (210) 209-0642

172 Creekside Park Rd
Ste 117
Spring Branch, TX 78070
Phone (210) 209-0642

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": "1547769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547769600000",
    "number": "1083188338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26229 N CRANES MILL RD",
            "city": "CANYON LAKE",
            "state": "TX",
            "postal_code": "781331957",
            "telephone_number": "210-833-3804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26229 N CRANES MILL RD",
            "city": "CANYON LAKE",
            "state": "TX",
            "postal_code": "781331957",
            "telephone_number": "830-214-1825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITTLE",
        "first_name": "MELANIE",
        "middle_name": "D",
        "credential": "LMSW, LCDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-18",
        "last_updated": "2019-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TX",
            "license": "66579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canyon Lake, TX

Sources for this page

Verify at the official NPI Registry.