Individual provider Active NPI

Peggy Diane Utecht, LCSW

  • Clinical Social Worker
  • Houston, TX
National Provider Identifier
1306827209
Registry record updated Aug 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
29776 Issued in TX
Practice address
401 Branard St
2
Houston, TX 77006-5015
Phone
(713) 529-0037
Fax
(713) 526-4367
NPI assigned
Nov 8, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2010

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 29776 TX Primary

Addresses

Primary practice location

401 Branard St
2
Houston, TX 77006-5015

Mailing address

401 Branard St
2
Houston, TX 77006-5015
Phone (713) 529-0037

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
I20051215000783 TX Practitioner - Clinical Social Worker 5991726010 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians

Practice addresses (Care Compare)

2021 Guadalupe St
Suite 260
Austin, TX 78705-5654
Phone (866) 630-0966

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29776TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC Clinical CurrentSince Sep 7, 2022 Accepting new patients
The Montrose Center Clinical CurrentSince Apr 4, 2000 Accepting new patients
Montrose Counseling Center, Inc. Past Accepting new patients

Locations

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

2222 Cleburne St
Houston, TX 77004
Phone (713) 497-5549

401 Branard St
Fl 2
Houston, TX 77006
Phone (713) 529-0037

Organizations & group practices 3

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": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282176000000",
    "number": "1306827209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 BRANARD ST",
            "address_2": "2",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770065015",
            "telephone_number": "713-529-0037",
            "fax_number": "713-526-4367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 BRANARD ST",
            "address_2": "2",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770065015",
            "telephone_number": "713-529-0037",
            "fax_number": "713-526-4367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UTECHT",
        "first_name": "PEGGY",
        "middle_name": "DIANE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-08",
        "last_updated": "2010-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "29776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.