Active NPI
Gerardo Javier Ungo, LCSW
- Clinical Social Worker
- Austin, TX
National Provider Identifier
1740842210
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 51891
- Practice address
- 100 W Dean Keeton St FL 5
Austin, TX 78712-1091 - Phone
- (512) 471-3515
- NPI assigned
- Jul 3, 2019
- Sex
- Male
- Sole proprietor
- Yes
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 | 51891 | TX | Primary |
Addresses
Primary practice location
100 W Dean Keeton St FL 5
Austin, TX 78712-1091
Mailing address
6916 Vassar Dr
Austin, TX 78723-2222
Phone (512) 633-7384
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 51891 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614124800000",
"number": "1740842210",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6916 VASSAR DR",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787232222",
"telephone_number": "512-633-7384"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 W DEAN KEETON ST FL 5",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787121091",
"telephone_number": "512-471-3515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UNGO",
"first_name": "GERARDO",
"middle_name": "JAVIER",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-07-03",
"last_updated": "2021-02-24",
"certification_date": "2021-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "51891",
"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 Feb 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.