Individual provider Active NPI

Camille Jones, LCSW

  • Clinical Social Worker
  • Austin, TX
National Provider Identifier
1225803257
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
105167 Issued in TX
Practice address
4009 Victory Dr Apt A105
Austin, TX 78704-7545
Phone
(512) 517-9206
NPI assigned
Nov 20, 2023
Last updated
Nov 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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 105167 TX Primary

Addresses

Primary practice location

4009 Victory Dr Apt A105
Austin, TX 78704-7545

Mailing address

4009 Victory Dr Apt A105
Austin, TX 78704-7545

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241121004820 TX Practitioner - Clinical Social Worker 4183159502 Reassigns benefits to 2 organizations
I20250908001673 CA Practitioner - Clinical Social Worker 4183159502 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
105167TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Clinical CurrentSince Aug 5, 2025 Accepting new patients
Grow Healthcare Group PA Clinical CurrentSince Oct 1, 2024 Accepting new patients
Uplift Behavioral Health PC Clinical CurrentSince Sep 2, 2024 Accepting new patients
Shine Medical Providers PC Past Accepting new patients
Shine Medical of Ca PC Past Accepting new patients

Locations

1423 Broadway
Ste 1152
Oakland, CA 94612

325 S 1st St
Ste 200
San Jose, CA 95113
Phone (415) 839-7564

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

211 E 7th St
Ste 620
Austin, TX 78701
Phone (415) 742-8411

500 E Saint Johns Ave
Ste 2620
Austin, TX 78752
Phone (512) 829-1742

8911 N Capital of Texas Hwy
Ste 4200
Austin, TX 78759
Phone (512) 207-0586

700 Milam St
Ste 1300
Houston, TX 77002
Phone (281) 801-8391

Organizations & group practices 5

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": "1700438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1225803257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4009 VICTORY DR APT A105",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787047545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4009 VICTORY DR APT A105",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787047545",
            "telephone_number": "512-517-9206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "CAMILLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-20",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "105167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.