NPIMap

Organization Active NPI

Live Oak Collective LLC

  • Clinical Social Worker
  • Austin, TX
National Provider Identifier
1841944857
Registry record updated Feb 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
LIVE OAK COLLECTIVE LLC
Practice address
2603 Willow St
Austin, TX 78702-5631
Phone
(512) 765-6657
NPI assigned
Feb 8, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sarah Elizabeth Kincheloe, LCSW-SNPI 1134401995
Title
Co Owner
Phone
(512) 765-6657

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

2603 Willow St
Austin, TX 78702-5631

Mailing address

2603 Willow St
Austin, TX 78702-5631
Phone (512) 765-6657

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL None

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220505000884 TX Part B Supplier - Clinic/Group Practice 9133516404 Receives reassigned benefits from 9 practitioners
Practice locations: Austin, TX

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1201 Barbara Jordan Blvd
Ste 700
Austin, TX 78723
Phone (512) 765-6657

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1644278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644278400000",
    "number": "1841944857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2603 WILLOW ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787025631",
            "telephone_number": "512-765-6657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2603 WILLOW ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787025631",
            "telephone_number": "512-765-6657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVE OAK COLLECTIVE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-08",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A",
        "authorized_official_last_name": "KINCHELOE",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "CO OWNER",
        "authorized_official_telephone_number": "512-765-6657",
        "authorized_official_credential": "LCSW-S"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "None",
            "affiliation": "N",
            "address_1": "2603 Willow St",
            "city": "Austin",
            "state": "TX",
            "country_code": "US",
            "postal_code": "787025631",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Feb 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.