Jaime Guajardo Jr., LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

55233 Issued in TX

Practice address

2219 Sawdust Rd
Suite 1101
The Woodlands, TX 77380-2575

Phone

(832) 246-5364

NPI assigned

Jun 24, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Serenity Place Family Therapy LLC

  • Clinical Social Worker
  • The Woodlands, TX
  • NPI 1528523743
  Medicare reassignment

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

{
    "created_epoch": "1308873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1104112457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2219 SAWDUST RD",
            "address_2": "SUITE 1101",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773802575",
            "telephone_number": "832-246-5364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2219 SAWDUST RD",
            "address_2": "SUITE 1101",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773802575",
            "telephone_number": "832-246-5364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUAJARDO",
        "first_name": "JAIME",
        "name_suffix": "Jr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-24",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "55233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "397963501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grogan'S Mill Surgery Center, LLC
• Grogans Mill Dental, PC
• Lauren Grona Wells, PT, DPT
• Michael Patrick Groves, MA, NCC, LPC
• Gtbe Endeavors, Inc.
• Christine Gudan, CNIM
• Leslie Sabrina Guerra
• Thomas Guerrero-Garcia, M.D.
• Jessica Guevara, PA-C
• Evelin Guillen Leon, MD

• Clinical Social Worker in The Woodlands, TX
• Providers in The Woodlands, 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 May 22, 2023; 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.