Individual provider Active NPI

Christina Perez, LCSW

  • Clinical Social Worker
  • Pflugerville, TX
National Provider Identifier
1215518659
Registry record updated Apr 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
41000 Issued in TX
Practice address
1100 Sweet Leaf LN
Pflugerville, TX 78660-7943
Phone
(512) 251-4836
NPI assigned
Apr 17, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2021

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 41000 TX Primary

Addresses

Primary practice location

1100 Sweet Leaf LN
Pflugerville, TX 78660-7943

Mailing address

1100 Sweet Leaf LN
Pflugerville, TX 78660-7943
Phone (512) 251-4836

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
I20210609002888 TX Practitioner - Clinical Social Worker 5597165704 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
May accept Medicare assignment
Group practices
Connell and Associates LLCGroup PAC ID 9931335395, 6 clinicians

Practice addresses (Care Compare)

3106 S W S Young Dr
Suite B202
Killeen, TX 76542-2000
Phone (254) 628-0056

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
41000TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Oria, LLC CurrentSince Jun 11, 2021 Accepting new patients
Chrysalis Psychotherapy, PLLC CurrentSince May 16, 2022 Accepting new patients

Locations

3106 S W S Young Dr
Ste B202
Killeen, TX 76542
Phone (254) 628-0056

Organizations & group practices 3

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": "1618617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618617600000",
    "number": "1215518659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 SWEET LEAF LN",
            "city": "PFLUGERVILLE",
            "state": "TX",
            "postal_code": "786607943",
            "telephone_number": "512-251-4836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 SWEET LEAF LN",
            "city": "PFLUGERVILLE",
            "state": "TX",
            "postal_code": "786607943",
            "telephone_number": "512-251-4836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "CHRISTINA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-17",
        "last_updated": "2021-04-17",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "41000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pflugerville, TX

Sources for this page

Verify at the official NPI Registry.