Individual provider Active NPI

Kassidi McKayla Kaminski, LCSW

  • Clinical Social Worker
  • Austin, TX
National Provider Identifier
1487408464
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
106027 Issued in TX
Practice address
8500 N Mopac Expy Ste 601
Austin, TX 78759-8347
Phone
(713) 494-2224
NPI assigned
Apr 15, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 106027 TX
Clinical Social Worker 1041C0700X 106027 TX Primary

Addresses

Primary practice location

8500 N Mopac Expy Ste 601
Austin, TX 78759-8347

Mailing address

8500 N Mopac Expy Ste 601
Austin, TX 78759-8347
Phone (713) 494-2224

Other practice location 1

11551 Forest Central Dr Ste 202
Dallas, TX 75243-3920
Phone (844) 824-8775

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
I20250227004023 TX Practitioner - Clinical Social Worker 8325568751 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
106027TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Behavioral Health, PLLC Clinical CurrentSince Feb 26, 2025 Accepting new patients

Locations

11551 Forest Central Dr
Ste 202
Dallas, TX 75243
Phone (817) 751-7802

12505 Memorial Dr
Ste 230
Houston, TX 77024
Phone (210) 858-9078

1425 Greenway Dr
Ste 360
Irving, TX 75038
Phone (317) 362-3417

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": "1713139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1487408464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8500 N MOPAC EXPY STE 601",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787598347",
            "telephone_number": "713-494-2224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8500 N MOPAC EXPY STE 601",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787598347",
            "telephone_number": "713-494-2224"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11551 Forest Central Dr Ste 202",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752433920",
            "country_code": "US",
            "telephone_number": "844-824-8775",
            "fax_number": "281-648-2200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAMINSKI",
        "first_name": "KASSIDI",
        "middle_name": "MCKAYLA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-15",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TX",
            "license": "106027",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "106027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.