Individual provider Active NPI

Kristin R Sanders, LCSW-S

  • Clinical Social Worker
  • Cypress, TX
National Provider Identifier
1114160777
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
57692 Issued in TX
Practice address
14150 Huffmeister Rd
#200
Cypress, TX 77429
Phone
(281) 743-3468
NPI assigned
Apr 13, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34005708A IN
Clinical Social Worker 1041C0700X 57692 TX Primary

Addresses

Primary practice location

14150 Huffmeister Rd
#200
Cypress, TX 77429

Mailing address

14150 Huffmeister Rd #200
Cypress, TX 77429
Phone (281) 743-3468

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
I20200716002341 TX Practitioner - Clinical Social Worker 3274957766 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12262 Queenston Blvd
Houston, TX 77095-5361
Phone (281) 743-3468

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34005708AINMDClinical Social Worker
57692TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
The Olive Tree Counseling and Supervision Clinical CurrentSince Mar 31, 2020 Accepting new patients

Locations

12262 Queenston Blvd
Ste E
Houston, TX 77095
Phone (281) 743-3468

Organizations & group practices 1

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": "1239580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1114160777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14150 HUFFMEISTER RD #200",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "77429",
            "telephone_number": "281-743-3468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14150 HUFFMEISTER RD",
            "address_2": "#200",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "77429",
            "telephone_number": "281-743-3468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "KRISTIN",
        "middle_name": "R",
        "credential": "LCSW-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-13",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34005708A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "57692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cypress, TX

Sources for this page

Verify at the official NPI Registry.