Individual provider Active NPI

Carolyn Janine Sobotka, LCSW

  • Clinical Social Worker
  • San Antonio, TX
National Provider Identifier
1760139166
Registry record updated Mar 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
60148 Issued in TX
Practice address
7506 Quail Run Dr
San Antonio, TX 78209-3131
Phone
(210) 765-9134
NPI assigned
Mar 4, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2022

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 60148 TX Primary

Addresses

Primary practice location

7506 Quail Run Dr
San Antonio, TX 78209-3131

Mailing address

7506 Quail Run Dr
San Antonio, TX 78209-3131
Phone (210) 765-9134

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
I20220809002003 TX Practitioner - Clinical Social Worker 5193107043 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60148TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC Clinical CurrentSince Jul 27, 2022 Accepting new patients

Locations

2021 Guadalupe St
Ste 260
Austin, TX 78705
Phone (202) 932-9958

Organizations & group practices 1

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": "1646352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646352000000",
    "number": "1760139166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7506 QUAIL RUN DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782093131",
            "telephone_number": "210-765-9134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7506 QUAIL RUN DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782093131",
            "telephone_number": "210-765-9134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOBOTKA",
        "first_name": "CAROLYN",
        "middle_name": "JANINE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-04",
        "last_updated": "2022-03-04",
        "certification_date": "2022-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "60148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.