Individual provider Active NPI

Catherine Rachelle Wooding, LCSW

  • Clinical Social Worker
  • College Station, TX
National Provider Identifier
1285909812
Registry record updated Apr 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
42143 Issued in TX
Practice address
205 Pronghorn Loop
College Station, TX 77845-4311
Phone
(817) 707-8657
NPI assigned
Mar 15, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2014

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 42143 TX Primary

Addresses

Primary practice location

205 Pronghorn Loop
College Station, TX 77845-4311

Mailing address

205 Pronghorn Loop
College Station, TX 77845-4311
Phone (817) 707-8657

Other names 1

  • Catherine Rachelle Ballew Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2006COMDProfessional Counselor
42143TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Deer Oaks Mental Health Associates PC 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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1331769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398297600000",
    "number": "1285909812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 PRONGHORN LOOP",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778454311",
            "telephone_number": "817-707-8657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 PRONGHORN LOOP",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778454311",
            "telephone_number": "817-707-8657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODING",
        "first_name": "CATHERINE",
        "middle_name": "RACHELLE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-15",
        "last_updated": "2014-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "42143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CATHERINE",
            "last_name": "BALLEW",
            "middle_name": "RACHELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in College Station, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.