Individual provider Active NPI

Danielle Antaki Coy, LCSW

  • Clinical Social Worker
  • Houston, TX
National Provider Identifier
1164057287
Registry record updated Mar 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
58806 Issued in TX
Practice address
3433 W Dallas St Apt 1083
Houston, TX 77019-3840
Phone
(281) 928-5131
NPI assigned
Mar 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2020

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 58806 TX Primary

Addresses

Primary practice location

3433 W Dallas St Apt 1083
Houston, TX 77019-3840

Mailing address

3433 W Dallas St Apt 1083
Houston, TX 77019-3840
Phone (281) 928-5131

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
I20210415001980 TX Practitioner - Clinical Social Worker 8426466228 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians

Practice addresses (Care Compare)

2021 Guadalupe St
Suite 260
Austin, TX 78705-5654
Phone (866) 630-0966

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
58806TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC Clinical CurrentSince Apr 12, 2021 Accepting new patients

Locations

2021 Guadalupe St
Ste 260
Austin, TX 78705
Phone (202) 932-9958

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": "1583712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583712000000",
    "number": "1164057287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3433 W DALLAS ST APT 1083",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770193840",
            "telephone_number": "281-928-5131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3433 W DALLAS ST APT 1083",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770193840",
            "telephone_number": "281-928-5131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COY",
        "first_name": "DANIELLE",
        "middle_name": "ANTAKI",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-09",
        "last_updated": "2020-03-09",
        "certification_date": "2020-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "58806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.