Individual provider Active NPI

Jesse Paul Newborn, SOCIAL WORKER

  • Clinical Social Worker
  • San Antonio, TX
National Provider Identifier
1396786240
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
S06146 Issued in TX
Practice address
10615 Perrin Beitel Rd
Ste 406
San Antonio, TX 78217-3141
Phone
(210) 572-8327
Fax
(210) 828-8333
NPI assigned
Jun 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 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 S06146 TX Primary

Addresses

Primary practice location

10615 Perrin Beitel Rd
Ste 406
San Antonio, TX 78217-3141

Mailing address

23602 Northwood LN
San Antonio, TX 78259-1603
Phone (210) 497-7584

Other identifiers 1

IdentifierTypeStateIssuer
147191401MedicaidTX

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
I20050221000500 TX Practitioner - Clinical Social Worker 5698727485 Practice locations: San Antonio, TX

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3030 Nacogdoches Rd
Suite 120
San Antonio, TX 78217-4502
Phone (210) 771-5117

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S06146TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Vida Counseling PLLC Clinical PastSince Sep 10, 2023 Accepting new patients

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": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1396786240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23602 NORTHWOOD LN",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782591603",
            "telephone_number": "210-497-7584",
            "fax_number": "210-497-5463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10615 PERRIN BEITEL RD",
            "address_2": "STE 406",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782173141",
            "telephone_number": "210-572-8327",
            "fax_number": "210-828-8333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWBORN",
        "first_name": "JESSE",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "SOCIAL WORKER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "S06146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "147191401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.