Individual provider Active NPI

Emily Rachelle Times, LCSW

  • Clinical Social Worker
  • Waco, TX
National Provider Identifier
1669150041
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
69435 Issued in TX
Practice address
2800 Lyle Ave
Waco, TX 76708-2680
Phone
(254) 297-7100
NPI assigned
Jul 6, 2023
Last updated
Jul 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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 69435 TX Primary

Addresses

Primary practice location

2800 Lyle Ave
Waco, TX 76708-2680

Mailing address

PO Box 890
Waco, TX 76703-0890
Phone (254) 752-3451

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
I20230816004050 TX Practitioner - Clinical Social Worker 2264894641 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

110 S 12TH St
Waco, TX 76701-1810
Phone (254) 297-7124

114 S 12TH St
Waco, TX 76701-1810
Phone (254) 752-3451

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Heart of Texas Region MHMR Center CurrentSince Jul 1, 2023 Accepting new patients
Waco Internal Medicine Associates, P.a. PastSince Jul 9, 2023 Accepting new patients

Locations

110 S 12th St
Waco, TX 76701
Phone (254) 297-7124

2800 Lyle Ave
Waco, TX 76708
Phone (254) 297-7100

Organizations & group practices 2

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": "1688601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1669150041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 890",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767030890",
            "telephone_number": "254-752-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 LYLE AVE",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767082680",
            "telephone_number": "254-297-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIMES",
        "first_name": "EMILY",
        "middle_name": "RACHELLE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-06",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "69435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.