Active NPI
Kristen Adams, LCSW
- Clinical Social Worker
- Georgetown, TX
National Provider Identifier
1609164086
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 61513
- Practice address
- 4230 Williams Dr
Georgetown, TX 78628-1330 - Phone
- (737) 808-4888
- NPI assigned
- Jul 19, 2011
- Last updated
- Mar 3, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 27018 | CA | |
| Clinical Social Worker | 1041C0700X | 61513 | TX | Primary |
Addresses
Primary practice location
4230 Williams Dr
Georgetown, TX 78628-1330
Mailing address
4230 Williams Dr Unit 2
Georgetown, TX 78628-1330
Phone (737) 808-4888
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2024 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61513 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646265600000",
"number": "1609164086",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4230 WILLIAMS DR UNIT 2",
"city": "GEORGETOWN",
"state": "TX",
"postal_code": "786281330",
"telephone_number": "737-808-4888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4230 WILLIAMS DR",
"city": "GEORGETOWN",
"state": "TX",
"postal_code": "786281330",
"telephone_number": "737-808-4888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADAMS",
"first_name": "KRISTEN",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-07-19",
"last_updated": "2022-03-03",
"certification_date": "2021-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "27018",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "61513",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Georgetown, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.