Active NPI
Mary Sorrels, LCSW
- Clinical Social Worker
- Austin, TX
National Provider Identifier
1598788010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 29443
- Practice address
- 1643 E 2ND St
Building C
Austin, TX 78702-4411 - Phone
- (512) 445-7787
- Fax
- (512) 440-4059
- NPI assigned
- Jul 25, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 29443 | TX | Primary |
Addresses
Primary practice location
1643 E 2ND St
Building C
Austin, TX 78702-4411
Mailing address
PO Box 3548
Austin, TX 78764-3548
Phone (512) 445-7787
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 149084901 | Medicaid | TX |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29443 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222819200000",
"number": "1598788010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3548",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787643548",
"telephone_number": "512-445-7787",
"fax_number": "512-440-4059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1643 E 2ND ST",
"address_2": "BUILDING C",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787024411",
"telephone_number": "512-445-7787",
"fax_number": "512-440-4059"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SORRELS",
"first_name": "MARY",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-25",
"last_updated": "2008-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "29443",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "149084901",
"state": "TX"
}
],
"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 Oct 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.