Individual provider Active NPI

Leslie Mitchell, LCSW

  • Clinical Social Worker
  • San Antonio, TX
National Provider Identifier
1750157574
Registry record updated Dec 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
38595 Issued in TX
Practice address
1620 Somerset Rd
San Antonio, TX 78211-3021
Phone
(210) 924-6684
NPI assigned
Dec 1, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 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 38595 TX Primary

Addresses

Primary practice location

1620 Somerset Rd
San Antonio, TX 78211-3021

Mailing address

9726 Gypsy CV
Converse, TX 78109-2943

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
I20241122002601 TX Practitioner - Clinical Social Worker 1759816028 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Care Center LLCGroup PAC ID 5991064420, 703 clinicians

Practice addresses (Care Compare)

430 W Sunset Rd
San Antonio, TX 78209-1736
Phone (888) 374-5066

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38595TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Center LLC, CurrentSince Sep 16, 2024 Accepting new patients
Family Care Center, LLC CurrentSince Sep 16, 2024 Accepting new patients
Dva Healthcare Renal Care Inc PastSince Jan 14, 2024 Accepting new patients
Dva Healthcare Renal Care Inc PastSince Jan 14, 2024 Accepting new patients
Shine Medical Providers PC Past Accepting new patients

Locations

551 S Interstate 35
Ste 200
Round Rock, TX 78664
Phone (512) 241-7314

430 W Sunset Rd
San Antonio, TX 78209
Phone (210) 824-4584

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1701388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702684800000",
    "number": "1750157574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9726 GYPSY CV",
            "city": "CONVERSE",
            "state": "TX",
            "postal_code": "781092943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 SOMERSET RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782113021",
            "telephone_number": "210-924-6684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "LESLIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-01",
        "last_updated": "2023-12-16",
        "certification_date": "2023-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "38595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.