Individual provider Active NPI

Angelique Umutesi, LCSW

  • Clinical Social Worker
  • Austin, TX
National Provider Identifier
1679387641
Registry record updated Mar 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
108139 Issued in TX
Practice address
5900 Balcones Dr Ste 100
Austin, TX 78731-4298
Phone
(210) 901-8094
NPI assigned
Feb 1, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 108139 TX Primary
Clinical Social Worker 1041C0700X LC200004381 DC
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 130836 CA

Addresses

Primary practice location

5900 Balcones Dr Ste 100
Austin, TX 78731-4298

Mailing address

PO Box 460074
Escondido, CA 92046-0074
Phone (210) 901-8094

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20260116000408 TX Practitioner - Clinical Social Worker 1456838887 Reassigns benefits to 2 organizations
I20260202003097 CA Practitioner - Clinical Social Worker 1456838887 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

13904 Capewood LN
Apt 352
San Diego, CA 92128-4248

5900 Balcones Dr
Austin, TX 78731-4200

PO Box
New York, NY 10087

PO Box
Suite 460074
Escondido, CA 92046

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
130836CAMDClinical Social Worker
LC200004381DCMDClinical Social Worker
108139TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Roots & Refuge Center LLC Single Specialty CurrentSince Nov 20, 2025 Accepting new patients

Locations

5900 Balcones Dr
Ste 100
Austin, TX 78731

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1738368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773964800000",
    "number": "1679387641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 460074",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920460074",
            "telephone_number": "210-901-8094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 BALCONES DR STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787314298",
            "telephone_number": "210-901-8094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UMUTESI",
        "first_name": "ANGELIQUE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-01",
        "last_updated": "2026-03-20",
        "certification_date": "2026-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "108139",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC200004381",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "130836",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.