Laura Bauer, LCSW
Individual provider Active NPI Clinical Social Worker · Bryan, TX
NPI 1194429241 · NPPES record last updated Mar 30, 2023
Key facts
- NPI
- 1194429241
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 68669 (TX)
- Practice address
- 2490 Boonville Rd
Bryan, TX 77808-2326 - Phone
- (979) 703-1808
- NPI assigned
- Mar 30, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 1, 2024 through May 1, 2028
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 68669 | TX | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 68669 | TX | Yes |
Addresses
Primary practice location
2490 Boonville Rd
Bryan, TX 77808-2326
Mailing address
2490 Boonville Rd
Bryan, TX 77808-2326
Phone (979) 703-1808
Other providers in Bryan, TX
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- Suzanne M Bastian
- Bennie B Batson
- Latomia Batts
- Porsha Evette Batts
- Alexandra Kristan Baxley
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All providers in Bryan, TX · Clinical Social Worker in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 30, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.