Individual provider Active NPI

Kristen Martinez

  • Clinical Social Worker
  • Fort Worth, TX
National Provider Identifier
1063206936
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
68215 Issued in TX
Practice address
101 Summit Ave Ste 204
Fort Worth, TX 76102-2609
Phone
(214) 530-0021
Fax
(214) 530-0021
NPI assigned
Apr 7, 2025
Last updated
Apr 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 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 68215 TX Primary

Addresses

Primary practice location

101 Summit Ave Ste 204
Fort Worth, TX 76102-2609

Mailing address

8150 N Central Expy Ste 1625
Dallas, TX 75206-1806
Phone (214) 530-0021

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
I20250821002484 TX Practitioner - Clinical Social Worker 5799285078 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Taylor Counseling GroupGroup PAC ID 7012360019, 36 clinicians

Practice addresses (Care Compare)

101 Summit Ave
Suite 204
Fort Worth, TX 76102-2609
Phone 21453000210

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
68215TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Taylor Counseling Group CurrentSince Aug 5, 2025 Accepting new patients

Locations

8150 N Central Expy
Ste 1625
Dallas, TX 75206
Phone 97957437170

101 Summit Ave
Ste 204
Fort Worth, TX 76102

550 Westcott St
Ste 220
Houston, TX 77007

300 N Ih 35 E
Waxahachie, TX 75165
Phone (214) 733-4747

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1743984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1063206936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8150 N CENTRAL EXPY STE 1625",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752061806",
            "telephone_number": "214-530-0021",
            "fax_number": "214-530-0021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SUMMIT AVE STE 204",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761022609",
            "telephone_number": "214-530-0021",
            "fax_number": "214-530-0021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "KRISTEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-07",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "68215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.