Individual provider Active NPI

Courtney Watkins, LCSW

  • Clinical Social Worker
  • Fort Worth, TX
National Provider Identifier
1083368799
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
65755 Issued in TX
Practice address
6512 Ellis Rd
Fort Worth, TX 76112-4106
Phone
(682) 232-5105
NPI assigned
Feb 10, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 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 65755 TX Primary

Addresses

Primary practice location

6512 Ellis Rd
Fort Worth, TX 76112-4106

Mailing address

6512 Ellis Rd
Fort Worth, TX 76112-4106
Phone (682) 232-5105

Electronic endpoints 1

TypeEndpointUseAffiliation
RESTful URL Axis2 Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20240404001465 OR Practitioner - Clinical Social Worker 6406294800 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
May accept Medicare assignment
Group practices
Asher Community Health CenterGroup PAC ID 2163460726, 5 clinicians

Practice addresses (Care Compare)

PO Box
Suite 307
Fossil, OR 97830-0307

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
65755TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Asher Community Health Center CurrentSince Feb 6, 2024 Accepting new patients
Asher Community Health Center CurrentSince Feb 6, 2024 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: courtney.smith.p2@direct.kthfs.nextgenshare.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1644451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1083368799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6512 ELLIS RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761124106",
            "telephone_number": "682-232-5105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6512 ELLIS RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761124106",
            "telephone_number": "682-232-5105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "COURTNEY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-10",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "65755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "REST",
            "endpointTypeDescription": "RESTful URL",
            "endpoint": "Axis2",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6512 Ellis Rd",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761124106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.