Individual provider Active NPI

Dagmar Chinchilla, LCSW

  • Clinical Social Worker
  • Katy, TX
National Provider Identifier
1124435219
Registry record updated May 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
64686 Issued in TX
Practice address
24022 Cinco Village Center Blvd
Katy, TX 77494-8397
Phone
(281) 391-9696
NPI assigned
Jul 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Social Worker 104100000X 096187-1 NY
Clinical Social Worker 1041C0700X 64686 TX Primary

Addresses

Primary practice location

24022 Cinco Village Center Blvd
Katy, TX 77494-8397

Mailing address

24022 Cinco Village Center Blvd Ste 100
Katy, TX 77494-8390
Phone (281) 391-9696

Other practice location 1

344 Fulton Ave
Hempstead, NY 11550-3923
Phone (516) 538-2613

Other practice location 2

21715 Kingsland Blvd
Katy, TX 77450-2543
Phone (281) 398-7353

Other practice location 3

175 Fulton Ave Ste 304
Hempstead, NY 11550-3702
Phone (516) 884-2360

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
096187-1NYMDSocial Worker
64686TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
TCH Pediatric Associates, Inc Past Accepting new patients
SK Mental Health Counseling Services PLLC Social Worker PastSince Sep 5, 2021 Accepting new patients
TCH Pediatric Associates, Inc Past Accepting new patients

Organizations & group practices 3

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": "1405900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683849600000",
    "number": "1124435219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24022 CINCO VILLAGE CENTER BLVD STE 100",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774948390",
            "telephone_number": "281-391-9696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24022 CINCO VILLAGE CENTER BLVD",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774948397",
            "telephone_number": "281-391-9696"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "344 Fulton Ave",
            "address_purpose": "LOCATION",
            "city": "Hempstead",
            "state": "NY",
            "postal_code": "115503923",
            "country_code": "US",
            "telephone_number": "516-538-2613",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21715 Kingsland Blvd",
            "address_purpose": "LOCATION",
            "city": "Katy",
            "state": "TX",
            "postal_code": "774502543",
            "country_code": "US",
            "telephone_number": "281-398-7353",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "175 Fulton Ave Ste 304",
            "address_purpose": "LOCATION",
            "city": "Hempstead",
            "state": "NY",
            "postal_code": "115503702",
            "country_code": "US",
            "telephone_number": "516-884-2360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHINCHILLA",
        "first_name": "DAGMAR",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-21",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "096187-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "64686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.