Individual provider Active NPI

Kamini D Verma, LCSW

  • Clinical Social Worker
  • Georgetown, TX
National Provider Identifier
1578019022
Registry record updated Sep 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
54790 Issued in TX
Practice address
2423 Williams Dr
Suite 108
Georgetown, TX 78628-3200
Phone
(877) 800-5722
Fax
(512) 869-8424
NPI assigned
Aug 25, 2016
Last updated
Sep 14, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2018

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 54790 TX Primary

Addresses

Primary practice location

2423 Williams Dr
Suite 108
Georgetown, TX 78628-3200

Mailing address

345 Cypress Creek Rd
Ste 102
Cedar Park, TX 78613-4484
Phone (512) 955-3074

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
I20161116001770 TX Practitioner - Clinical Social Worker 1658650502 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
54790TXMDClinical Social Worker

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1472083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536883200000",
    "number": "1578019022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 CYPRESS CREEK RD",
            "address_2": "STE 102",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786134484",
            "telephone_number": "512-955-3074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2423 WILLIAMS DR",
            "address_2": "SUITE 108",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786283200",
            "telephone_number": "877-800-5722",
            "fax_number": "512-869-8424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERMA",
        "first_name": "KAMINI",
        "middle_name": "D",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-25",
        "last_updated": "2018-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "54790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, TX

Sources for this page

Verify at the official NPI Registry.