Individual provider Active NPI

Sharon Ballestero, LCSW

  • Clinical Social Worker
  • Houston, TX
National Provider Identifier
1689080830
Registry record updated Sep 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
63235 Issued in TX
Practice address
3811 Lyons Ave
Houston, TX 77020-8306
Phone
(832) 548-5000
NPI assigned
Jul 9, 2014
Last updated
Sep 21, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2017

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 63235 TX Primary

Addresses

Primary practice location

3811 Lyons Ave
Houston, TX 77020-8306

Mailing address

PO Box 66308
Houston, TX 77266-6308

Other identifiers 1

IdentifierTypeStateIssuer
63235OtherTXTEXAS LICENSE

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
I20171010002758 TX Practitioner - Clinical Social Worker 1658646070 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1305 Benson St
Houston, TX 77020-4044
Phone (713) 924-0600

3811 Lyons Ave
Houston, TX 77020-8306
Phone (832) 548-5400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
63235TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Community Health Services, Inc CurrentSince Sep 21, 2017 Accepting new patients
Legacy Community Health Services, Inc CurrentSince Sep 21, 2017 Accepting new patients

Locations

3811 Lyons Ave
Houston, TX 77020
Phone (832) 548-5400

6441 High Star Dr
Houston, TX 77074
Phone (832) 548-5300

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": "1404864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505952000000",
    "number": "1689080830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 66308",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772666308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3811 LYONS AVE",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770208306",
            "telephone_number": "832-548-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLESTERO",
        "first_name": "SHARON",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-09",
        "last_updated": "2017-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "63235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS LICENSE",
            "identifier": "63235",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.