Individual provider Active NPI

Gwendolyn Marentes, LCSW

  • Clinical Social Worker
  • Helotes, TX
National Provider Identifier
1376912717
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
54024 Issued in TX
Practice address
12274 Bandera Rd Ste 238
Helotes, TX 78023-4727
Phone
(325) 864-6949
NPI assigned
Sep 16, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 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 54024 TX Primary

Addresses

Primary practice location

12274 Bandera Rd Ste 238
Helotes, TX 78023-4727

Mailing address

12274 Bandera Rd Ste 238
Helotes, TX 78023-4727
Phone (325) 864-6949

Other identifiers 1

IdentifierTypeStateIssuer
354473601MedicaidTX

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
I20151113000790 TX Practitioner - Clinical Social Worker 6800106212 Practice locations: Abilene, TX

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

702 Hickory
Suite C
Abilene, TX 79601-5038

702 Hickory St
Suite C
Abilene, TX 79601-5038
Phone (325) 864-6949

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1442361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1376912717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12274 BANDERA RD STE 238",
            "city": "HELOTES",
            "state": "TX",
            "postal_code": "780234727",
            "telephone_number": "325-864-6949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12274 BANDERA RD STE 238",
            "city": "HELOTES",
            "state": "TX",
            "postal_code": "780234727",
            "telephone_number": "325-864-6949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARENTES",
        "first_name": "GWENDOLYN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-16",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "54024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "354473601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Helotes, TX

Sources for this page

Verify at the official NPI Registry.