Active NPI
Mark Elliott, L.C.S.W.
- Clinical Social Worker
- Austin, TX
National Provider Identifier
1750766671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 56790
- Practice address
- 1006 E 39TH St
Austin, TX 78751-5207 - Phone
- (512) 766-6275
- Fax
- (512) 717-5111
- NPI assigned
- Jul 21, 2015
- 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 | 56790 | TX | Primary |
Addresses
Primary practice location
1006 E 39TH St
Austin, TX 78751-5207
Mailing address
1006 E 39TH St
Austin, TX 78751-5207
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 |
|---|---|---|---|
| 56790 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463616000000",
"number": "1750766671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1006 E 39TH ST",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787515207"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1006 E 39TH ST",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787515207",
"telephone_number": "512-766-6275",
"fax_number": "512-717-5111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIOTT",
"first_name": "MARK",
"credential": "L.C.S.W.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-07-21",
"last_updated": "2016-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "56790",
"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 May 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.