Individual provider Active NPI

Nikki Sanusi, LCSW-S

  • Clinical Social Worker
  • Pearland, TX
National Provider Identifier
1427308089
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
40695 Issued in TX
Practice address
2404 S Grand Blvd
Pearland, TX 77581-4299
Phone
(832) 304-1846
NPI assigned
Sep 11, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 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 40695 TX Primary

Addresses

Primary practice location

2404 S Grand Blvd
Pearland, TX 77581-4299

Mailing address

2404 S Grand Blvd
Pearland, TX 77581-4299
Phone (832) 304-1846

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
I20130529000787 TX Practitioner - Clinical Social Worker 9032357215 Reassigns benefits to 1 organization
Practice locations: Baytown, TX

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Community Health Services, Inc CurrentSince May 11, 2018 Accepting new patients
Legacy Community Health Services, Inc CurrentSince May 11, 2018 Accepting new patients

Locations

4301 Garth Rd
Baytown, TX 77521
Phone (281) 420-5760

4301 Garth Rd
Ste 302
Baytown, TX 77521
Phone (281) 420-8400

3509 Garth Rd
Baytown, TX 77521
Phone (832) 548-5215

6441 High Star Dr
Houston, TX 77074
Phone (832) 548-5300

Organizations & group practices 2

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": "1347321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1427308089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2404 S GRAND BLVD",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775814299",
            "telephone_number": "832-304-1846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2404 S GRAND BLVD",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775814299",
            "telephone_number": "832-304-1846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANUSI",
        "first_name": "NIKKI",
        "name_prefix": "Mrs.",
        "credential": "LCSW-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-11",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "40695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearland, TX

Sources for this page

Verify at the official NPI Registry.