Individual provider Active NPI

Jarred Eugene Wellington, LCSW

  • Clinical Social Worker
  • Austin, TX
National Provider Identifier
1548954316
Registry record updated Jun 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
104438 Issued in TX
Practice address
10101 S 1St St
Austin, TX 78748-6655
Phone
(512) 961-0597
NPI assigned
Jun 5, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

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 104438 TX Primary

Addresses

Primary practice location

10101 S 1St St
Austin, TX 78748-6655

Mailing address

1430 Collier St
Austin, TX 78704-2911
Phone (512) 804-3076

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
I20230908000172 TX Practitioner - Clinical Social Worker 0143684290 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Travis County Mental Health and Mental Retardation Center CurrentSince Jun 6, 2023 Accepting new patients
Austin Travis County Mental Health and Mental Retardation Center Clinical CurrentSince Jun 6, 2023 Accepting new patients

Locations

1430 Collier St
Austin, TX 78704
Phone (512) 427-4357

5015 S Interstate 35
Austin, TX 78744
Phone (512) 703-1392

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": "1685923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1548954316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 COLLIER ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787042911",
            "telephone_number": "512-804-3076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 S 1ST ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787486655",
            "telephone_number": "512-961-0597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLINGTON",
        "first_name": "JARRED",
        "middle_name": "EUGENE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-05",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "104438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.