Individual provider Active NPI

Keren- Happuch Lynne Simmons, LCSW

  • Clinical Social Worker
  • McKinney, TX
National Provider Identifier
1285250696
Registry record updated Jun 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
40181 Issued in TX
Practice address
2170 N Lake Forest Dr
McKinney, TX 75071-5156
Phone
(718) 506-1115
NPI assigned
Jun 22, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2020

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 40181 TX Primary

Addresses

Primary practice location

2170 N Lake Forest Dr
McKinney, TX 75071-5156

Mailing address

236 Morris LN
Greenville, TX 75402-5450
Phone (718) 506-1115

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
I20200625003188 TX Practitioner - Clinical Social Worker 4981026689 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Supportive Care LLCGroup PAC ID 7719126655, 67 clinicians

Practice addresses (Care Compare)

4910 Wellington St
Greenville, TX 75402-6007
Phone (718) 298-4375

Merit-based Incentive Payment System (MIPS)

Final score
88.99 of 100Reported as group
Quality
80
Improvement activities
40
Cost
66.63

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Supportive Care LLC CurrentSince Jun 15, 2020 Accepting new patients
Assurasource LTD Clinical CurrentSince Jun 21, 2020 Accepting new patients
Sondermind Provider Network LLC Clinical CurrentSince Jul 27, 2021 Accepting new patients

Locations

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

400 N Allen Dr
Ste 204
Allen, TX 75013

2021 Guadalupe St
Ste 260
Austin, TX 78705
Phone (202) 932-9958

4910 Wellington St
Greenville, TX 75402
Phone (903) 454-3772

2170 N Lake Forest Dr
McKinney, TX 75071
Phone (817) 268-8103

825 W Kearney St
Mesquite, TX 75149
Phone (972) 288-7660

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": "1592784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592784000000",
    "number": "1285250696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 MORRIS LN",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754025450",
            "telephone_number": "718-506-1115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2170 N LAKE FOREST DR",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750715156",
            "telephone_number": "718-506-1115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "KEREN- HAPPUCH",
        "middle_name": "LYNNE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-22",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "40181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McKinney, TX

Sources for this page

Verify at the official NPI Registry.