Individual provider Active NPI

Daisy Thompson, LCSW, LCDC

  • Clinical Social Worker
  • Austin, TX
National Provider Identifier
1790143162
Registry record updated Feb 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
58303 Issued in TX
Practice address
4117 Vinalopo Dr
Austin, TX 78738-6994
Phone
(541) 805-4340
NPI assigned
Feb 1, 2016
Last updated
Feb 1, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2016

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 58303 TX Primary

Addresses

Primary practice location

4117 Vinalopo Dr
Austin, TX 78738-6994

Mailing address

4117 Vinalopo Dr
Austin, TX 78738-6994
Phone (541) 805-4340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20170822004167 OR Practitioner - Clinical Social Worker 1052615374 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2301 Cove Ave
La Grande, OR 97850-3906
Phone (541) 962-8800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Human Development, Inc. CurrentSince Jun 11, 2017 Accepting new patients

Locations

2301 Cove Ave
La Grande, OR 97850
Phone (541) 962-8800

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, 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": "1454284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454284800000",
    "number": "1790143162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4117 VINALOPO DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787386994",
            "telephone_number": "541-805-4340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4117 VINALOPO DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787386994",
            "telephone_number": "541-805-4340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "DAISY",
        "credential": "LCSW, LCDC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-01",
        "last_updated": "2016-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "58303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.