James Gordon Minto Jr., MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

35983 Issued in TX

Practice address

3000 Polar LN Ste 101
Cedar Park, TX 78613-3065

Phone

(844) 824-8775

NPI assigned

Oct 24, 2006

Last updated

Aug 26, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 9

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

Specialty

Clinical Social Worker

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Progressive Behavioral Health, PLLCGroup PAC ID 4486794906, 366 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Progressive Behavioral Health, PLLC

  dba LifeStance Health

  • Mental Health Counselor
  • Friendswood, TX
  • NPI 1659567238

  Clinical

  Medicare reassignment Care Compare group NPD
• Addiction Treatment Resources, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Greenville, TX
  • NPI 1457417289
  NPD (past) Authorized official

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1962586180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4702 WESLEY ST STE D",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754015663",
            "telephone_number": "903-455-4114",
            "fax_number": "903-455-2814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 POLAR LN STE 101",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786133065",
            "telephone_number": "844-824-8775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 E Palm Valley Blvd Ste 240",
            "address_purpose": "LOCATION",
            "city": "Round Rock",
            "state": "TX",
            "postal_code": "786643043",
            "country_code": "US",
            "telephone_number": "844-824-8775",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4702 Wesley St Ste D",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "TX",
            "postal_code": "754015663",
            "country_code": "US",
            "telephone_number": "903-455-4114",
            "fax_number": "903-455-2814",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MINTO",
        "first_name": "JAMES",
        "middle_name": "GORDON",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "35983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "1756453",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0007800054",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS/NORTHSTAR",
            "identifier": "079049",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143465603",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMPSYCH",
            "identifier": "244277",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "00007JB",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN HEALTH",
            "identifier": "146452000",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "203630",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE HEALTHCARE SYSTEM",
            "identifier": "317895",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mimitom Transportation LLC
• Kyunghwan Min, DMD
• Mindful Purpose Therapy, PLLC
• Amanda Beth Ming Ulloa, DC
• Vanessa Tran Minnick, O.D.
• Kyla Mione, LPC
• Ketakumari Mistry, PHARM. D. R.PH.
• Shalini Mittal, DDS
• Joda Kay Miura, LCSW
• Lori D Mock-Blair, PA-C

• Clinical Social Worker in Cedar Park, TX
• Providers in Cedar Park, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.