Individual provider Active NPI

Karin Clements, LCSW

  • Clinical Social Worker
  • Longview, TX
National Provider Identifier
1487303392
Registry record updated Dec 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
59574 Issued in TX
Practice address
1011 W Loop 281 Ste 5
Longview, TX 75604-2932
Phone
(903) 309-1834
NPI assigned
Mar 20, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 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 59574 TX Primary

Addresses

Primary practice location

1011 W Loop 281 Ste 5
Longview, TX 75604-2932

Mailing address

4459 Smelley Rd
Longview, TX 75605-6117
Phone (903) 309-1834

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
I20220627000552 TX Practitioner - Clinical Social Worker 9739568478 Reassigns benefits to 2 organizations
Practice locations: Longview, TX

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians

Practice addresses (Care Compare)

1011 W Loop
281 Suite 5
Longview, TX 75604-2932
Phone (903) 309-1834

2021 Guadalupe St
Suite 260
Austin, TX 78705-5654
Phone (866) 630-0966

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Christy R. Collins, LCSW Inc Clinical CurrentSince Mar 27, 2022 Accepting new patients
Karin Clements Counseling PLLC Clinical CurrentSince Sep 27, 2022 Accepting new patients
Sondermind Provider Network LLC Clinical CurrentSince Jun 22, 2022 Accepting new patients

Locations

2021 Guadalupe St
Ste 260
Austin, TX 78705
Phone (202) 932-9958

1011 W Loop 281
Ste 5
Longview, TX 75604
Phone (903) 309-1834

Organizations & group practices 3

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": "1647734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671148800000",
    "number": "1487303392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4459 SMELLEY RD",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756056117",
            "telephone_number": "903-309-1834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 W LOOP 281 STE 5",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756042932",
            "telephone_number": "903-309-1834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENTS",
        "first_name": "KARIN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-20",
        "last_updated": "2022-12-16",
        "certification_date": "2022-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "59574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.