Individual provider Active NPI

Jennifer Alissa Vasquez, PHD, LCSW-S

  • Clinical Social Worker
  • Austin, TX
National Provider Identifier
1912362641
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
54262 Issued in TX
Practice address
5900 Balcones Drive
Ste 12078
Austin, TX 78731
Phone
(512) 577-2255
NPI assigned
Dec 23, 2015
Last updated
Jul 16, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

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 54262 TX Primary

Addresses

Primary practice location

5900 Balcones Drive
Ste 12078
Austin, TX 78731

Mailing address

5900 Balcones Dr Ste 12078
Austin, TX 78731-4257
Phone (512) 785-7757

Other practice location 1

119 S Western Ave Unit 1
Chicago, IL 60612-4644
Phone (512) 577-2255

Other identifiers 1

IdentifierTypeStateIssuer
13663799OtherTXCAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Mar 16, 2024 through Mar 16, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
54262TXMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Inspiredpracticellc Clinical CurrentSince Mar 26, 2023 Accepting new patients
Yoga Jena Wellness LLC Clinical CurrentSince Apr 6, 2023 Accepting new patients

Locations

5900 Balcones Dr
Ste 12078
Austin, TX 78731
Phone (512) 577-2255

5900 Balcones Dr
Ste 12079
Austin, TX 78731
Phone (512) 577-2255

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1450828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784160000000",
    "number": "1912362641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 BALCONES DR STE 12078",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787314257",
            "telephone_number": "512-785-7757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 BALCONES DRIVE",
            "address_2": "STE 12078",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78731",
            "telephone_number": "512-577-2255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "119 S Western Ave Unit 1",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606124644",
            "country_code": "US",
            "telephone_number": "512-577-2255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VASQUEZ",
        "first_name": "JENNIFER",
        "middle_name": "ALISSA",
        "name_prefix": "Dr.",
        "credential": "PHD, LCSW-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-23",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "54262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13663799",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.