Individual provider Active NPI

James H Gottlich, LCSW

  • Clinical Social Worker
  • Fort Worth, TX
National Provider Identifier
1093712333
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
16626 Issued in TX
Practice address
3704 Mattison Ave
Fort Worth, TX 76107-2619
Phone
(817) 732-8441
Fax
(817) 732-1833
NPI assigned
Jul 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 16626 TX Primary

Addresses

Primary practice location

3704 Mattison Ave
Fort Worth, TX 76107-2619

Mailing address

3704 Mattison Ave
Fort Worth, TX 76107-2619
Phone (817) 732-8441

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
16626TXMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1093712333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3704 MATTISON AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761072619",
            "telephone_number": "817-732-8441",
            "fax_number": "817-732-1833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3704 MATTISON AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761072619",
            "telephone_number": "817-732-8441",
            "fax_number": "817-732-1833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTLICH",
        "first_name": "JAMES",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-01",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "16626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.