Individual provider Active NPI

Kelsie Villa

  • Clinical Social Worker
  • Waco, TX
National Provider Identifier
1942165154
Registry record updated Dec 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
111917 Issued in TX
Practice address
110 S 12TH St
Waco, TX 76701-1810
Phone
(254) 652-6922
NPI assigned
Dec 19, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 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 Worker 1041C0700X 111917 TX Primary

Addresses

Primary practice location

110 S 12TH St
Waco, TX 76701-1810

Mailing address

PO Box 890
Waco, TX 76703-0890
Phone (254) 652-6922

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
I20260203000375 TX Practitioner - Clinical Social Worker 3476031261 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Suite 890
Waco, TX 76703

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
111917TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Heart of Texas Region MHMR Center CurrentSince Dec 25, 2025 Accepting new patients

Locations

110 S 12th St
Waco, TX 76701
Phone (254) 297-7124

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": "1766102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766102400000",
    "number": "1942165154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 890",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767030890",
            "telephone_number": "254-652-6922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 S 12TH ST",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767011810",
            "telephone_number": "254-652-6922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLA",
        "first_name": "KELSIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-12-19",
        "last_updated": "2025-12-19",
        "certification_date": "2025-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "111917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.