Active NPI
Vanessa Dunham, LCSW
- Clinical Social Worker
- Round Rock, TX
National Provider Identifier
1093308876
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 51279
- Practice address
- 2410 Round Rock Ave Ste 250
Round Rock, TX 78681-4003 - Phone
- (512) 687-0347
- NPI assigned
- Feb 12, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 51279 | TX | Primary |
Addresses
Primary practice location
2410 Round Rock Ave Ste 250
Round Rock, TX 78681-4003
Mailing address
2410 Round Rock Ave Ste 250
Round Rock, TX 78681-4003
Phone (512) 687-0347
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51279 | Other | TX | SOCIAL WORK LICENSE NUMBER FROM TEXAS BEHAVIORAL HEALTH EXECUTIVE COUNCIL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 21, 2024 through Jun 21, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 51279 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1613088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613088000000",
"number": "1093308876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2410 ROUND ROCK AVE STE 250",
"city": "ROUND ROCK",
"state": "TX",
"postal_code": "786814003",
"telephone_number": "512-687-0347"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2410 ROUND ROCK AVE STE 250",
"city": "ROUND ROCK",
"state": "TX",
"postal_code": "786814003",
"telephone_number": "512-687-0347"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNHAM",
"first_name": "VANESSA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-12",
"last_updated": "2021-02-12",
"certification_date": "2021-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "51279",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SOCIAL WORK LICENSE NUMBER FROM TEXAS BEHAVIORAL HEALTH EXECUTIVE COUNCIL",
"identifier": "51279",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Round Rock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.