Judith Virginia Andriola, LICENSED CLINICAL SO
Individual provider Active NPI Clinical Social Worker · Pearland, TX
NPI 1710014006 · NPPES record last updated Mar 25, 2009
Key facts
- NPI
- 1710014006
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- L29490 (TX)
- Practice address
- 2225 County Road 90 Ste 215
Pearland, TX 77584-5111 - Phone
- (281) 489-1290
- Fax
- (281) 489-8806
- NPI assigned
- Feb 27, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 1996
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
5705 Rose Hill CT
Rosharon, TX 77583-2054
Phone (979) 549-6202
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050211000100 | TX | Practitioner - Clinical Social Worker | 0446202030 | Practice locations: Rosharon, TX |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L29490 | TX | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | L29490 | TX | Yes |
| Counselor | 101Y00000X | 29490 | TX |
Addresses
Primary practice location
2225 County Road 90 Ste 215
Pearland, TX 77584-5111
Mailing address
5705 Rose Hill CT
Rosharon, TX 77583
Phone (713) 501-6904
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 170522002 | Medicaid | TX |
Other names
- Judith Virginia Weber
Other providers in Pearland, TX
- Dena Yvette Andrade
- Cheona Andreason
- Marilyn Rochelle Andrews
- Suzanne Andrews
- Tyisha Andrews
- Tami Nicole Andrus
- Anew Psychological Services, PLLC
- Angela M Frost
- Angelic Touch Health Services LLC
- Angels From Above Home Care, LLC
All providers in Pearland, TX · Clinical Social Worker in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 25, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.