Individual provider Active NPI

Nancy Pacheco, LCSW

  • Clinical Social Worker
  • Austin, TX
National Provider Identifier
1477263283
Registry record updated Dec 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
63356 Issued in TX
Practice address
1625 Rutherford LN
Austin, TX 78754-5173
Phone
(512) 651-6150
NPI assigned
Dec 2, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2022

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 63356 TX Primary

Addresses

Primary practice location

1625 Rutherford LN
Austin, TX 78754-5173

Mailing address

2120 Brunswick Dr
Austin, TX 78723-2053
Phone (512) 954-1979

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

State licenses

LicenseStateTypeSpecialty
63356TXMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1669939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669939200000",
    "number": "1477263283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 BRUNSWICK DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787232053",
            "telephone_number": "512-954-1979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 RUTHERFORD LN",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787545173",
            "telephone_number": "512-651-6150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACHECO",
        "first_name": "NANCY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-02",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "63356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2022; 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.