Individual provider Active NPI

Stephanie Nicole Burgess, LCSW

  • Clinical Social Worker
  • Austin, TX
National Provider Identifier
1831855816
Registry record updated Dec 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
57937 Issued in TX
Practice address
2021 Guadalupe St Ste 260
Austin, TX 78705-5654
Phone
(512) 387-4939
NPI assigned
Nov 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2021

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 57937 TX Primary

Addresses

Primary practice location

2021 Guadalupe St Ste 260
Austin, TX 78705-5654

Mailing address

2021 Guadalupe St Ste 260
Austin, TX 78705-5654

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, IN, ND3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20220228000138 TX Practitioner - Clinical Social Worker 6800280306 Reassigns benefits to 1 organization
I20260112001606 IN Practitioner - Clinical Social Worker 6800280306 Reassigns benefits to 1 organization
I20260120000545 ND Practitioner - Clinical Social Worker 6800280306 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians

Practice addresses (Care Compare)

2021 Guadalupe St
Suite 260
Austin, TX 78705-5654
Phone (866) 630-0966

333 N Alabama St
Suite 350
Indianapolis, IN 46204-2275
Phone (866) 630-0966

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6970NDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC Clinical CurrentSince Feb 17, 2022 Accepting new patients
Sondermind, P.a. Clinical CurrentSince Dec 8, 2025 Accepting new patients

Locations

333 N Alabama St
Ste 350
Indianapolis, IN 46204
Phone (317) 983-0002

1531 32nd Ave S
Ste 102
Fargo, ND 58103
Phone (281) 762-0659

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

Organizations & group practices 2

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": "1636761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1831855816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 GUADALUPE ST STE 260",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787055654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 GUADALUPE ST STE 260",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787055654",
            "telephone_number": "512-387-4939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "STEPHANIE",
        "middle_name": "NICOLE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-13",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "57937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.