Holistic Kidney Counseling, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

39918 Issued in TX

Legal business name

HOLISTIC KIDNEY COUNSELING, PLLC

Practice address

2500 Wilcrest Dr
Houston, TX 77042-2752

Phone

(281) 673-7950

NPI assigned

Jul 13, 2018

Last updated

Jul 13, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

San Chieu Ta, LCSWNPI 1619465275

Title

License Clinical Social Worker

Phone

(281) 673-7950

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• San Chieu Ta, LCSW

  • Clinical Social Worker
  • Houston, TX
  • NPI 1619465275
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1531440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531440000000",
    "number": "1184100026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9107 GIANNA CT",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770838015",
            "telephone_number": "281-673-7950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 WILCREST DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770422752",
            "telephone_number": "281-673-7950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLISTIC KIDNEY COUNSELING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-13",
        "last_updated": "2018-07-13",
        "status": "A",
        "authorized_official_last_name": "TA",
        "authorized_official_first_name": "SAN",
        "authorized_official_middle_name": "CHIEU",
        "authorized_official_title_or_position": "LICENSE CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "281-673-7950",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "39918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Houston, TX
• Providers in Houston, 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 Jul 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.