Individual provider Active NPI

Jessica Leah Al Kassem, LCSW-S

  • Clinical Social Worker
  • Grapevine, TX
National Provider Identifier
1841422490
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
60320 Issued in TX
Practice address
1135 S Main Street
Grapevine, TX 76051
Phone
(469) 845-9448
NPI assigned
Aug 17, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 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 60320 TX Primary

Addresses

Primary practice location

1135 S Main Street
Grapevine, TX 76051

Mailing address

1135 S Main Street
Grapevine, TX 76051
Phone (469) 845-9448

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
60320TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Munay Heart Center Counseling, PLLC Clinical CurrentSince Nov 1, 2018 Accepting new patients

Locations

3500 Oak Lawn Ave
Ste 230
Dallas, TX 75219
Phone (214) 247-6410

3333 Lee Pkwy
Ste 600
Dallas, TX 75219
Phone (817) 533-0825

1135 S Main St
Grapevine, TX 76051
Phone (817) 329-5041

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": "1250467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1841422490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 S MAIN STREET",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "76051",
            "telephone_number": "469-845-9448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 S MAIN STREET",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "76051",
            "telephone_number": "469-845-9448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL KASSEM",
        "first_name": "JESSICA",
        "middle_name": "LEAH",
        "name_prefix": "Ms.",
        "credential": "LCSW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-17",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "60320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grapevine, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.