Carol Derochie Albert, LCSW – Clinical Social Worker

Key facts

NPI: 1104248343
Entity type: Individual (NPI type 1)
Primary specialty: Clinical Social Worker 1041C0700X
License: 18402 (TX)
Practice address: 96 Crossroads Blvd Ste 250
San Antonio, TX 78201-6523
Phone: (210) 736-0106
Fax: (210) 736-2609
NPI assigned: Jan 7, 2014
Sex: Female
Sole proprietor: Yes

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
18402	TX	MD	Professional Counselor

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Clinical Social Worker	1041C0700X	18402	TX	Yes

Addresses

Primary practice location

96 Crossroads Blvd Ste 250
San Antonio, TX 78201-6523

Mailing address

96 Crossroads Blvd Ste 250
San Antonio, TX 78201-6523
Phone (210) 736-0106

Other names

Ms. Carol Lynn Derochie Former name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 7, 2014.

{
    "created_epoch": "1389052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389052800000",
    "number": "1104248343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 CROSSROADS BLVD STE 250",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782016523",
            "telephone_number": "210-736-0106",
            "fax_number": "210-736-2609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 CROSSROADS BLVD STE 250",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782016523",
            "telephone_number": "210-736-0106",
            "fax_number": "210-736-2609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALBERT",
        "first_name": "CAROL",
        "middle_name": "DEROCHIE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-07",
        "last_updated": "2014-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "18402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROL",
            "last_name": "DEROCHIE",
            "middle_name": "LYNN",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Antonio, TX

All providers in San Antonio, TX · Clinical Social Worker in Texas

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 7, 2014. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.