Individual provider Active NPI

Rayne Ventimiglia, LCSW

  • Clinical Social Worker
  • Bedford, TX
National Provider Identifier
1720441017
Registry record updated Aug 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
53329 Issued in TX
Practice address
1901 Central Dr Ste 812
Bedford, TX 76021-5858
Phone
(817) 874-8169
NPI assigned
Apr 4, 2016
Last updated
Aug 5, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2021

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 53329 TX Primary

Addresses

Primary practice location

1901 Central Dr Ste 812
Bedford, TX 76021-5858

Mailing address

1611 Pheasant LN
Southlake, TX 76092-3436
Phone (817) 874-8169

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
I20180306002754 TX Practitioner - Clinical Social Worker 9436410511 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Let It Rain Psychotherapy PLLCGroup PAC ID 8527329606, 2 clinicians

Practice addresses (Care Compare)

7165 Colleyville Blvd
Suite 102
Colleyville, TX 76034-8010
Phone (817) 874-8169

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
53329TXMDPsychiatric Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Let It Rain Psychotherapy, PLLC Clinical CurrentSince Feb 21, 2018 Accepting new patients

Locations

1901 Central Dr
Ste 716
Bedford, TX 76021
Phone (817) 874-8169

1901 Central Dr
Ste 812
Bedford, TX 76021
Phone (817) 874-8169

7165 Colleyville Blvd
Ste 102
Colleyville, TX 76034
Phone (817) 778-4048

Organizations & group practices 1

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": "1459728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628121600000",
    "number": "1720441017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 PHEASANT LN",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760923436",
            "telephone_number": "817-874-8169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 CENTRAL DR STE 812",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760215858",
            "telephone_number": "817-874-8169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENTIMIGLIA",
        "first_name": "RAYNE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-04",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "53329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, TX

Sources for this page

Verify at the official NPI Registry.