Individual provider Active NPI

Andrea Skoglund, LCSW

  • Clinical Social Worker
  • Missouri City, TX
National Provider Identifier
1891760021
Registry record updated Jul 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
52381 Issued in TX
Practice address
8615 S Fitzgerald Way
Missouri City, TX 77459-2475
Phone
(832) 247-8066
NPI assigned
Feb 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2015

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 52381 TX Primary

Addresses

Primary practice location

8615 S Fitzgerald Way
Missouri City, TX 77459-2475

Mailing address

8615 S Fitzgerald Way
Missouri City, TX 77459-2475
Phone (832) 247-8066

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20190225001060 TX Practitioner - Clinical Social Worker 4688688096 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4502 Riverstone Blvd
Suite 804
Missouri City, TX 77459-5205
Phone (832) 247-8066

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
52381TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Andrea Skoglund, PLLC Clinical CurrentSince Dec 21, 2018 Accepting new patients

Locations

4502 Riverstone Blvd
Ste 804
Missouri City, TX 77459
Phone (832) 247-8066

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": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436745600000",
    "number": "1891760021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8615 S FITZGERALD WAY",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774592475",
            "telephone_number": "832-247-8066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8615 S FITZGERALD WAY",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774592475",
            "telephone_number": "832-247-8066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOGLUND",
        "first_name": "ANDREA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-21",
        "last_updated": "2015-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "52381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missouri City, TX

Sources for this page

Verify at the official NPI Registry.