Individual provider Active NPI

Sarah Michelle Waltz, LCSW

  • Clinical Social Worker
  • San Antonio, TX
National Provider Identifier
1093341505
Registry record updated Mar 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
68867 Issued in TX
Practice address
4203 Woodcock Dr Ste 216
San Antonio, TX 78228-1312
Phone
(210) 564-9116
Fax
(210) 564-9087
NPI assigned
Mar 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2022

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 68867 TX Primary

Addresses

Primary practice location

4203 Woodcock Dr Ste 216
San Antonio, TX 78228-1312

Mailing address

9100 W Ih 10 Ste 210
San Antonio, TX 78230-3149
Phone (210) 928-3900

Other identifiers 1

IdentifierTypeStateIssuer
68867OtherTXLICENSED MASTER SOCIAL WOK

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
I20230828003603 TX Order and Referring Only - Clinical Social Worker 3870980261

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
68867TXMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1584316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647475200000",
    "number": "1093341505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9100 W IH 10 STE 210",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782303149",
            "telephone_number": "210-928-3900",
            "fax_number": "219-855-5974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4203 WOODCOCK DR STE 216",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782281312",
            "telephone_number": "210-564-9116",
            "fax_number": "210-564-9087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTZ",
        "first_name": "SARAH",
        "middle_name": "MICHELLE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-16",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "68867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED MASTER SOCIAL WOK",
            "identifier": "68867",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.