Individual provider Active NPI

Courtney Renee Warncke

  • Clinical Social Worker
  • Missouri City, TX
National Provider Identifier
1396590725
Registry record updated Apr 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
4855 Riverstone Blvd Ste 102
Missouri City, TX 77459-4378
Phone
(832) 945-3139
NPI assigned
Apr 19, 2024
Last updated
Apr 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 104434 TX
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

4855 Riverstone Blvd Ste 102
Missouri City, TX 77459-4378

Mailing address

4855 Riverstone Blvd Ste 102
Missouri City, TX 77459-4378
Phone (832) 945-3139

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
I20240724000093 TX Practitioner - Clinical Social Worker 2860938016 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heart to Heart Counseling Service LLCGroup PAC ID 1052753712, 6 clinicians

Practice addresses (Care Compare)

4855 Riverstone Blvd
Suite 102
Missouri City, TX 77459-4378
Phone (832) 945-3139

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
104434TXMDClinical Social Worker

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": "1713484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1396590725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4855 RIVERSTONE BLVD STE 102",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774594378",
            "telephone_number": "832-945-3139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4855 RIVERSTONE BLVD STE 102",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774594378",
            "telephone_number": "832-945-3139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARNCKE",
        "first_name": "COURTNEY",
        "middle_name": "RENEE",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-19",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "104434",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missouri City, TX

Sources for this page

Verify at the official NPI Registry.