Individual provider Active NPI

Kathy Lee Siepker, PHD, MSW, LCSW, CDP

  • Clinical Social Worker
  • Grapevine, TX
National Provider Identifier
1932987633
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
104496 Issued in TX
Practice address
1705 W Northwest Hwy Ste 175
Grapevine, TX 76051-8124
Phone
(314) 971-7258
NPI assigned
Sep 15, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 104496 TX Primary

Addresses

Primary practice location

1705 W Northwest Hwy Ste 175
Grapevine, TX 76051-8124

Mailing address

1705 W Northwest Hwy Ste 175
Grapevine, TX 76051-8124
Phone (214) 613-3074

Other practice location 1

2021 Guadalupe St Ste 260
Austin, TX 78705-5654
Phone (314) 971-7258

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
I20241008002717 TX Practitioner - Clinical Social Worker 1951832419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BMSC TX LLCGroup PAC ID 1052680949, 21 clinicians

Practice addresses (Care Compare)

3405 El Salido Pkwy
Apt 236
Cedar Park, TX 78613-5647
Phone (855) 241-7160

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
104496TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
BMSC TX LLC Clinical CurrentSince Aug 15, 2024 Accepting new patients

Locations

10204 Bode St
Ste C
Plainfield, IL 60585
Phone (630) 844-7077

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": "1694736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1932987633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 W NORTHWEST HWY STE 175",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760518124",
            "telephone_number": "214-613-3074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 W NORTHWEST HWY STE 175",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760518124",
            "telephone_number": "314-971-7258"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2021 Guadalupe St Ste 260",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787055654",
            "country_code": "US",
            "telephone_number": "314-971-7258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIEPKER",
        "first_name": "KATHY",
        "middle_name": "LEE",
        "credential": "PHD, MSW, LCSW, CDP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-15",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "104496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grapevine, TX

Sources for this page

Verify at the official NPI Registry.