Individual provider Active NPI

Jered Dane Benedick, LCSW

  • Clinical Social Worker
  • Harker Heights, TX
National Provider Identifier
1619122314
Registry record updated Jun 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
40408 Issued in TX
Practice address
775 Indian TRL
Ste. 200
Harker Heights, TX 76548
Phone
(877) 800-5722
Fax
(254) 698-3247
NPI assigned
Nov 21, 2008
Last updated
Jun 27, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2025

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 40408 TX Primary

Addresses

Primary practice location

775 Indian TRL
Ste. 200
Harker Heights, TX 76548

Mailing address

2423 Williams Dr Ste 107
Georgetown, TX 78628-3269
Phone (877) 800-5722

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jered.benedick.p1@direct.lscctx.nextgenshare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lone Star Circle of Care CurrentSince Jul 26, 2025 Accepting new patients

Locations

205 E University Ave
Ste 200
Georgetown, TX 78626
Phone (512) 686-0207

2423 Williams Dr
Ste 107
Georgetown, TX 78628
Phone (512) 686-0207

Interoperability endpoints

  • Direct secure messaging: jered.benedick.1@29821.direct.athenahealth.com
  • Direct secure messaging: jered.benedick.p1@direct.lscctx.nextgenshare.com

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": "1227225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1619122314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2423 WILLIAMS DR STE 107",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786283269",
            "telephone_number": "877-800-5722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 INDIAN TRL",
            "address_2": "STE. 200",
            "city": "HARKER HEIGHTS",
            "state": "TX",
            "postal_code": "76548",
            "telephone_number": "877-800-5722",
            "fax_number": "254-698-3247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENEDICK",
        "first_name": "JERED",
        "middle_name": "DANE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-21",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "40408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jered.benedick.p1@direct.lscctx.nextgenshare.com",
            "affiliation": "N",
            "address_1": "775 Indian Trl",
            "address_2": "Ste. 200",
            "city": "Harker Heights",
            "state": "TX",
            "country_code": "US",
            "postal_code": "76548",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Harker Heights, TX

Sources for this page

Verify at the official NPI Registry.