Individual provider Active NPI

Stacie Yates

  • Clinical Social Worker
  • Houston, TX
National Provider Identifier
1720761166
Registry record updated Nov 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
104710 Issued in TX
Practice address
5901 Long Dr
Houston, TX 77087-1003
Phone
(713) 970-7000
NPI assigned
Aug 11, 2023
Last updated
Nov 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2023

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 104710 TX Primary

Addresses

Primary practice location

5901 Long Dr
Houston, TX 77087-1003

Mailing address

5901 Long Dr
Houston, TX 77087-1003
Phone (713) 970-7000

Other practice location 1

9401 Southwest Fwy
Houston, TX 77074-1407
Phone (713) 970-7000

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
I20231206001220 TX Practitioner - Clinical Social Worker 5294184065 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Harris Center for Mental Health and Idd CurrentSince Oct 23, 2023 Accepting new patients
The Harris Center for Mental Health and Idd PastSince Aug 13, 2023 Accepting new patients

Locations

1502 Taub Loop
Houston, TX 77030
Phone (713) 873-4900

5901 Long Dr
Houston, TX 77087
Phone (713) 970-4300

9401 Southwest Fwy
Houston, TX 77074
Phone (713) 970-3344

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": "1691712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700611200000",
    "number": "1720761166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 LONG DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770871003",
            "telephone_number": "713-970-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 LONG DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770871003",
            "telephone_number": "713-970-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9401 Southwest Fwy",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770741407",
            "country_code": "US",
            "telephone_number": "713-970-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YATES",
        "first_name": "STACIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-11",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "104710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.