Individual provider Active NPI

Beverly Solomon, LCSW

  • Clinical Social Worker
  • The Woodlands, TX
National Provider Identifier
1275656985
Registry record updated Jan 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
04136 Issued in TX
Practice address
26515 Oak Ridge Dr
The Woodlands, TX 77380-1966
Phone
(281) 419-1080
Fax
(281) 419-0357
NPI assigned
Apr 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 04136 TX
Clinical Social Worker 1041C0700X 04136 TX Primary

Addresses

Primary practice location

26515 Oak Ridge Dr
The Woodlands, TX 77380-1966

Mailing address

26515 Oak Ridge Dr
The Woodlands, TX 77380-1966
Phone (281) 419-1080

Other identifiers 1

IdentifierTypeStateIssuer
000000S38LOtherTXBC BS TEXAS

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
I20150319000406 TX Practitioner - Clinical Social Worker 6103143706 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
04136TXMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Sighbenn Healing and Cultural Place PastSince May 1, 2008 Accepting new patients

Organizations & group practices 2

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": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421366400000",
    "number": "1275656985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26515 OAK RIDGE DR",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773801966",
            "telephone_number": "281-419-1080",
            "fax_number": "281-419-0357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26515 OAK RIDGE DR",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773801966",
            "telephone_number": "281-419-1080",
            "fax_number": "281-419-0357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLOMON",
        "first_name": "BEVERLY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-09",
        "last_updated": "2015-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "04136",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "04136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS TEXAS",
            "identifier": "000000S38L",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in The Woodlands, TX

Sources for this page

Verify at the official NPI Registry.