Mary Angela Casanova, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

50231 Issued in TX

Practice address

1314 N Brazos St
Whitney, TX 76692-2010

Phone

(254) 694-3621

Fax

(254) 694-7436

NPI assigned

May 17, 2007

Last updated

Jun 7, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Randall Henderson, D.O. PLLCGroup PAC ID 3274759303, 6 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.

• Randall Henderson, D.O. PLLC

  dba Whitney Family Medicine

  • Family Medicine Physician
  • Whitney, TX
  • NPI 1366862310
  Medicare reassignment Care Compare group NPD
• Shine Medical Providers PC

  • Psychiatry Physician
  • Philadelphia, PA
  • NPI 1538894050
  NPD (past)

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1063629335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2177",
            "city": "WHITNEY",
            "state": "TX",
            "postal_code": "766925177",
            "telephone_number": "254-488-8409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 N BRAZOS ST",
            "city": "WHITNEY",
            "state": "TX",
            "postal_code": "766922010",
            "telephone_number": "254-694-3621",
            "fax_number": "254-694-7436"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Londonderry Dr",
            "address_purpose": "LOCATION",
            "city": "Waco",
            "state": "TX",
            "postal_code": "767127915",
            "country_code": "US",
            "telephone_number": "254-867-6550 x2010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CASANOVA",
        "first_name": "MARY",
        "middle_name": "ANGELA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TX",
            "license": "50231",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "50231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Bransom
• Brazos Professional Counseling PLLC
• Brookshire Grocery Company (Brookshires Pharmacy)
• Mellissa May Bruce, APRN-CNP
• Lisa Cannon
• CGH Dilley LLC
• Ronald Keith Chiles, DDS
• City of Whitney
• Clayton Pickering DO, PA.
• Clifford N. Auten, D.D.S,

• Clinical Social Worker in Whitney, TX
• Providers in Whitney, 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 Jun 7, 2022; 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.