Individual provider Active NPI

Kelly Ann Reinhart, LCSW

  • Clinical Social Worker
  • El Paso, TX
National Provider Identifier
1194291989
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
108562 Issued in TX
Practice address
11200 Sean Haggerty Dr Apt 3203
El Paso, TX 79934-3393
Phone
(505) 316-1732
NPI assigned
Oct 18, 2018
Last updated
Feb 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C-11216 NM
Clinical Social Worker 1041C0700X LCSW-21560 AZ
Clinical Social Worker 1041C0700X 108562 TX Primary

Addresses

Primary practice location

11200 Sean Haggerty Dr Apt 3203
El Paso, TX 79934-3393

Mailing address

385 Calle de Alegra Ste a
Las Cruces, NM 88005-3423
Phone (575) 526-1105

Other practice location 1

105 W Griggs Ave
Las Cruces, NM 88001-1235
Phone (575) 647-2879

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20240826003440 AZ Practitioner - Clinical Social Worker 5092135004 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-21560AZMDClinical Social Worker
C-11216NMMDClinical Social Worker
108562TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Holon Health Great Lakes, P.C. CurrentSince Jun 1, 2024 Accepting new patients
Honor the Light, LLC Clinical Current Accepting new patients
La Clinica de Familia, Incorporated PastSince Oct 7, 2020 Accepting new patients
Holon Health, Inc. Past Accepting new patients

Locations

4433 E Broadway Blvd
Ste 101
Tucson, AZ 85711

5650 S 12th Ave
Ste 132
Tucson, AZ 85706

3540 Pump Rd
Richmond, VA 23233
Phone (804) 404-6270

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1539820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1194291989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 CALLE DE ALEGRA STE A",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880053423",
            "telephone_number": "575-526-1105",
            "fax_number": "575-524-4266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11200 SEAN HAGGERTY DR APT 3203",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799343393",
            "telephone_number": "505-316-1732"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 W Griggs Ave",
            "address_purpose": "LOCATION",
            "city": "Las Cruces",
            "state": "NM",
            "postal_code": "880011235",
            "country_code": "US",
            "telephone_number": "575-647-2879",
            "fax_number": "575-647-2898",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REINHART",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-18",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-11216",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-21560",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "108562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.