Active NPI
Joseph Patrick Smullen, LCSW-S
- Social Worker
- Victoria, TX
National Provider Identifier
1972843407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 57483
- Practice address
- 5606 N Navarro St Ste 302a
Victoria, TX 77904-1770 - Phone
- (361) 210-6898
- Fax
- (832) 324-7856
- NPI assigned
- Feb 20, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 574813 | TX | |
| Social Worker | 104100000X | 57483 | TX | Primary |
Addresses
Primary practice location
5606 N Navarro St Ste 302a
Victoria, TX 77904-1770
Mailing address
604E Polk Ave
Victoria, TX 77901-2604
Phone (361) 237-0729
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170410000690 | TX | Practitioner - Clinical Social Worker | 7315223179 | Practice locations: Victoria, TX |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
5606 N Navarro St
Suite 302C
Victoria, TX 77904-1770
Phone (361) 210-6898
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 574813 | TX | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Raul R Capitaine Mdpa | Current | Accepting new patients |
Locations
1801 N Laurent St
Ste 107
Victoria, TX 77901
Phone (361) 212-8300
1402 Village Dr
Ste A
Victoria, TX 77901
Phone (361) 570-1444
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1361318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696204800000",
"number": "1972843407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "604E POLK AVE",
"city": "VICTORIA",
"state": "TX",
"postal_code": "779012604",
"telephone_number": "361-237-0729"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5606 N NAVARRO ST STE 302A",
"city": "VICTORIA",
"state": "TX",
"postal_code": "779041770",
"telephone_number": "361-210-6898",
"fax_number": "832-324-7856"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMULLEN",
"first_name": "JOSEPH",
"middle_name": "PATRICK",
"credential": "LCSW-S",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-02-20",
"last_updated": "2023-10-02",
"certification_date": "2023-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "574813",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "TX",
"license": "57483",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Victoria, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; 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.