Active NPI
Stephanie Nicole Burgess, LCSW
- Clinical Social Worker
- Austin, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 57937
- 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
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 | 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, ND
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 3
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6970 | ND | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sondermind Provider Network LLC | Clinical | Current | Accepting new patients |
| Sondermind, P.a. | Clinical | Current | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.