Individual provider Active NPI

Latoyia Medina, LCSW

  • Clinical Social Worker
  • Saginaw, TX
National Provider Identifier
1285324285
Registry record updated May 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
65386 Issued in TX
Practice address
712 Cardinal Dr
Saginaw, TX 76131-4876
Phone
(469) 831-4149
NPI assigned
May 11, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 11, 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 65386 TX Primary

Addresses

Primary practice location

712 Cardinal Dr
Saginaw, TX 76131-4876

Mailing address

712 Cardinal Dr
Saginaw, TX 76131-4876
Phone (469) 831-4149

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
I20231107003841 TX Practitioner - Clinical Social Worker 0749637106 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
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)

1201 Colonel Dr
Garland, TX 75043-1303
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

State licenses

LicenseStateTypeSpecialty
65386TXMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Supportive Care LLC CurrentSince Oct 15, 2023 Accepting new patients

Locations

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

1112 Smith Dr
Alvin, TX 77511
Phone (281) 331-3001

2660 Brickyard Rd
Beaumont, TX 77703
Phone (406) 892-1533

1201 Colonel Dr
Garland, TX 75043
Phone (210) 602-1140

1025 W Yeagua St
Groesbeck, TX 76642
Phone (254) 729-3366

6534 Stuebner Airline Rd
Houston, TX 77091
Phone (713) 692-5137

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

7820 Skyline Park Dr
Wht Settlemt, TX 76108
Phone (817) 246-4671

Organizations & group practices 1

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": "1683763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683763200000",
    "number": "1285324285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 CARDINAL DR",
            "city": "SAGINAW",
            "state": "TX",
            "postal_code": "761314876",
            "telephone_number": "469-831-4149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 CARDINAL DR",
            "city": "SAGINAW",
            "state": "TX",
            "postal_code": "761314876",
            "telephone_number": "469-831-4149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "LATOYIA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-11",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "65386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, TX

Sources for this page

Verify at the official NPI Registry.