Active NPI
Shonali Jacob
- Clinical Social Worker
- Bellaire, TX
National Provider Identifier
1679809693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 19290
- Practice address
- 5606 Evergreen St
Bellaire, TX 77401-4714 - Phone
- (713) 664-0639
- NPI assigned
- Oct 27, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 19290 | TX | Primary |
Addresses
Primary practice location
5606 Evergreen St
Bellaire, TX 77401-4714
Mailing address
5606 Evergreen St
Bellaire, TX 77401-4714
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2501 W William Cannon Dr
BLDG 6 Suite a
Austin, TX 78745-5282
Phone (512) 944-9135
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19290 | TX | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vonzee Interests LLC | Current | Accepting new patients | |
| Michelle Zee Enterprises LLC | Clinical | Past | Accepting new patients |
Locations
2501 W William Cannon Dr
Ste 6A
Austin, TX 78745
Phone (512) 344-9181
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.
-
- Mental Health Counselor
- Austin, TX
- NPI 1184857393
-
- Clinical Social Worker
- Austin, TX
- NPI 1417492232
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1256601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1256601600000",
"number": "1679809693",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5606 EVERGREEN ST",
"city": "BELLAIRE",
"state": "TX",
"postal_code": "774014714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5606 EVERGREEN ST",
"city": "BELLAIRE",
"state": "TX",
"postal_code": "774014714",
"telephone_number": "713-664-0639"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOB",
"first_name": "SHONALI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-10-27",
"last_updated": "2009-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "19290",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellaire, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.