Individual provider Active NPI

Cliff Chong, LCSW

  • Clinical Social Worker
  • Austin, TX
National Provider Identifier
1891366811
Registry record updated Jul 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
54557 Issued in TX
Practice address
2703 Sol Wilson Ave
Austin, TX 78702-2556
Phone
(512) 815-6478
NPI assigned
Jul 9, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 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 54557 TX Primary

Addresses

Primary practice location

2703 Sol Wilson Ave
Austin, TX 78702-2556

Mailing address

2003 Millay Dr
Austin, TX 78752-2131
Phone (512) 815-6478

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
54557TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cliff Chong Psychotherapy and Consultation PLLC Clinical Current Accepting new patients

Locations

2703 Sol Wilson Ave
Austin, TX 78702
Phone (512) 650-8179

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": "1625788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625788800000",
    "number": "1891366811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2003 MILLAY DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787522131",
            "telephone_number": "512-815-6478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2703 SOL WILSON AVE",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787022556",
            "telephone_number": "512-815-6478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHONG",
        "first_name": "CLIFF",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-09",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "54557",
            "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 Jul 9, 2021; 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.