Individual provider Active NPI

Sandra June Simmons, LCSW

  • Clinical Social Worker
  • San Antonio, TX
National Provider Identifier
1285899906
Registry record updated Jun 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
38078 Issued in TX
Practice address
4402 Vance Jackson Rd Ste 112
San Antonio, TX 78230-5333
Phone
(210) 724-2090
Fax
(210) 877-0939
NPI assigned
Jul 22, 2008
Last updated
Jun 9, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 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 38078 TX Primary

Addresses

Primary practice location

4402 Vance Jackson Rd Ste 112
San Antonio, TX 78230-5333

Mailing address

4323 Southeast Dr
San Antonio, TX 78222-4800
Phone (210) 724-2090

Other identifiers 2

IdentifierTypeStateIssuer
88447QOtherTXBCBS TX
194926502MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38078TXMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Darrell Parsons, LCSW, PLLC Clinical Past Accepting new patients

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, 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": "1216684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591660800000",
    "number": "1285899906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4323 SOUTHEAST DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782224800",
            "telephone_number": "210-724-2090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4402 VANCE JACKSON RD STE 112",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782305333",
            "telephone_number": "210-724-2090",
            "fax_number": "210-877-0939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "SANDRA",
        "middle_name": "JUNE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-22",
        "last_updated": "2020-06-09",
        "certification_date": "2020-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "38078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TX",
            "identifier": "88447Q",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "194926502",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.