Individual provider Active NPI

Kelsey Canavan Mantz, LCSW

  • Clinical Social Worker
  • San Antonio, TX
National Provider Identifier
1396669578
Registry record updated Aug 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
105479 Issued in TX
Practice address
202 Vanderheck St Apt 2
San Antonio, TX 78209-4045
Phone
(210) 865-7979
NPI assigned
Aug 8, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2026

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 105479 TX Primary

Addresses

Primary practice location

202 Vanderheck St Apt 2
San Antonio, TX 78209-4045

Mailing address

219 Kennedy Ave
San Antonio, TX 78209-5247
Phone (210) 865-7979

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1786147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786147200000",
    "number": "1396669578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 KENNEDY AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782095247",
            "telephone_number": "210-865-7979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 VANDERHECK ST APT 2",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782094045",
            "telephone_number": "210-865-7979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTZ",
        "first_name": "KELSEY",
        "middle_name": "CANAVAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-08",
        "last_updated": "2026-08-08",
        "certification_date": "2026-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "105479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2026; 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.