Active NPI
Maranda Medina, LCSW
- Clinical Social Worker
- Austin, TX
National Provider Identifier
1720726607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 67505
- Practice address
- 3001 Bee Caves Rd Ste 220
Austin, TX 78746-5590 - Phone
- (512) 777-2591
- NPI assigned
- May 22, 2022
- Sex
- Female
- Sole proprietor
- No
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 | 67505 | TX | Primary |
Addresses
Primary practice location
3001 Bee Caves Rd Ste 220
Austin, TX 78746-5590
Mailing address
3001 Bee Caves Rd Ste 220
Austin, TX 78746-5590
Phone (512) 777-2591
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668038400000",
"number": "1720726607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3001 BEE CAVES RD STE 220",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787465590",
"telephone_number": "512-777-2591"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3001 BEE CAVES RD STE 220",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787465590",
"telephone_number": "512-777-2591"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDINA",
"first_name": "MARANDA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-22",
"last_updated": "2022-11-10",
"certification_date": "2022-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "67505",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.