Individual provider Active NPI

Stanley Ivon Tubbs Jr., LCSW

  • Clinical Social Worker
  • Houston, TX
National Provider Identifier
1205015294
Registry record updated May 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
08537 Issued in TX
Practice address
401 Branard St FL 2
Houston, TX 77006-5015
Phone
(713) 529-0037
Fax
(713) 529-0498
NPI assigned
Oct 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2022

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 08537 TX Primary

Addresses

Primary practice location

401 Branard St FL 2
Houston, TX 77006-5015

Mailing address

401 Branard St FL 2
Houston, TX 77006-5015
Phone (713) 529-0037

Other identifiers 1

IdentifierTypeStateIssuer
142892202MedicaidTX

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
I20170322002724 TX Practitioner - Clinical Social Worker 1254591118 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1969
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Montrose CenterGroup PAC ID 8325020258, 8 clinicians

Practice addresses (Care Compare)

2222 Cleburne St
Houston, TX 77004-5177
Phone (713) 497-5549

401 Branard St
FL 2
Houston, TX 77006-5015
Phone (713) 529-0037

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08537TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Montrose Center Clinical CurrentSince Mar 13, 2017 Accepting new patients
Boys and Girls Country of Houston, Inc. Past Accepting new patients
Pawhuska Nursing Home, LLC PastSince Jan 11, 2005 Accepting new patients
Montrose Counseling Center, Inc. PastSince Jun 28, 2020 Accepting new patients

Locations

2222 Cleburne St
Houston, TX 77004
Phone (713) 497-5549

401 Branard St
Fl 2
Houston, TX 77006
Phone (713) 529-0037

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1193356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1205015294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 BRANARD ST FL 2",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770065015",
            "telephone_number": "713-529-0037",
            "fax_number": "713-529-0498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 BRANARD ST FL 2",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770065015",
            "telephone_number": "713-529-0037",
            "fax_number": "713-529-0498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUBBS",
        "first_name": "STANLEY",
        "middle_name": "IVON",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-26",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "08537",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142892202",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.