Individual provider Active NPI

Marcia Sherrod, LCSW

  • Social Worker
  • Austin, TX
National Provider Identifier
1639654742
Registry record updated Sep 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
64087 Issued in TX
Practice address
4361 S Congress Ave Unit 102
Austin, TX 78745-1289
Phone
(512) 772-3611
NPI assigned
Sep 25, 2018
Last updated
Sep 25, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 64087 TX Primary

Addresses

Primary practice location

4361 S Congress Ave Unit 102
Austin, TX 78745-1289

Mailing address

4361 S Congress Ave Unit 102
Austin, TX 78745-1289
Phone (512) 772-3611

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
64087TXMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Flourish Psychotherapy & Nutrition, LLC Past Accepting new patients

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": "1537833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537833600000",
    "number": "1639654742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4361 S CONGRESS AVE UNIT 102",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787451289",
            "telephone_number": "512-772-3611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4361 S CONGRESS AVE UNIT 102",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787451289",
            "telephone_number": "512-772-3611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERROD",
        "first_name": "MARCIA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-25",
        "last_updated": "2018-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TX",
            "license": "64087",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.