Active NPI
Jennifer Hoag Wydler, LCSW, LCDC
- Clinical Social Worker
- San Antonio, TX
National Provider Identifier
1992435283
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 69250
- Practice address
- 6333 De Zavala Rd
San Antonio, TX 78249-2115 - Phone
- (210) 399-4838
- NPI assigned
- Jun 10, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 13146 | TX | |
| Clinical Social Worker | 1041C0700X | 69250 | TX | Primary |
Addresses
Primary practice location
6333 De Zavala Rd
San Antonio, TX 78249-2115
Mailing address
5016 Brazoswood
San Antonio, TX 78244-2817
Phone (210) 441-0221
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jhoag_wydler@endeavors.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 69250 | TX | MD | Clinical Social Worker |
| 13146 | TX | MD | Community Health Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Endeavors, Inc | Past | Accepting new patients | |
| Family Endeavors, Inc. | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- El Paso, TX
- NPI 1538745484
-
- Adult Mental Health Clinic/Center
- San Antonio, TX
- NPI 1861647364
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656288000000",
"number": "1992435283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5016 BRAZOSWOOD",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782442817",
"telephone_number": "210-441-0221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6333 DE ZAVALA RD",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782492115",
"telephone_number": "210-399-4838"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOAG WYDLER",
"first_name": "JENNIFER",
"credential": "LCSW, LCDC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-10",
"last_updated": "2022-06-27",
"certification_date": "2022-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "TX",
"license": "13146",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "69250",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jhoag_wydler@endeavors.org",
"affiliation": "N",
"endpointDescription": "email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "email",
"address_1": "6333 De Zavala Rd",
"city": "San Antonio",
"state": "TX",
"country_code": "US",
"postal_code": "782492115",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.