Active NPI
Vickie Elaine Jessie, LCSW
- Clinical Social Worker
- Katy, TX
National Provider Identifier
1679874390
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 31384
- Practice address
- 26707 Wilderye Cove LN
Katy, TX 77493-4337 - Phone
- (832) 647-3125
- NPI assigned
- Nov 11, 2010
- 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 | 31384 | TX | Primary |
Addresses
Primary practice location
26707 Wilderye Cove LN
Katy, TX 77493-4337
Mailing address
26707 Wilderye Cove LN
Katy, TX 77493-4337
Phone (832) 647-3125
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31384 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1289433600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655856000000",
"number": "1679874390",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26707 WILDERYE COVE LN",
"city": "KATY",
"state": "TX",
"postal_code": "774934337",
"telephone_number": "832-647-3125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26707 WILDERYE COVE LN",
"city": "KATY",
"state": "TX",
"postal_code": "774934337",
"telephone_number": "832-647-3125"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JESSIE",
"first_name": "VICKIE",
"middle_name": "ELAINE",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-11-11",
"last_updated": "2022-06-22",
"certification_date": "2022-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "31384",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Katy, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.