Individual provider Active NPI

Bertha Trevino-Reyna, LCSW

  • Clinical Social Worker
  • Houston, TX
National Provider Identifier
1366950024
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
16441 Space Center Blvd Ste C-100
Houston, TX 77058-2015
Phone
(281) 480-7554
Fax
(281) 480-4641
NPI assigned
Jan 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

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 Primary

Addresses

Primary practice location

16441 Space Center Blvd Ste C-100
Houston, TX 77058-2015

Mailing address

16441 Space Center Blvd Ste C-100
Houston, TX 77058-2015
Phone (281) 480-7554

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
I20190218000673 TX Practitioner - Clinical Social Worker 6800851288 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
May accept Medicare assignment
Group practices
Carole and Ronald Krist Samaritan Counseling CenterGroup PAC ID 8325274152, 10 clinicians

Practice addresses (Care Compare)

16441 Space Ctr Blvd
Suite C100
Houston, TX 77058-2015
Phone (281) 480-7554

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Carole and Ronald Krist Samaritan Counseling Center Clinical CurrentSince Sep 26, 2018 Accepting new patients

Locations

16441 Space Center Blvd
#C100
Houston, TX 77058
Phone 28148075542743

6363 Research Forest Dr
The Woodlands, TX 77381
Phone 2814807554 ext. 2727

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": "1516060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1366950024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16441 SPACE CENTER BLVD STE C-100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770582015",
            "telephone_number": "281-480-7554",
            "fax_number": "281-480-4641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16441 SPACE CENTER BLVD STE C-100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770582015",
            "telephone_number": "281-480-7554",
            "fax_number": "281-480-4641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREVINO-REYNA",
        "first_name": "BERTHA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-16",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.