Active NPI
Elizabeth Guenevere Nieman, LCSW
- Clinical Social Worker
- Weatherford, TX
National Provider Identifier
1093942567
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 35290
- Practice address
- 109 Manor Court N. Willow Park
Weatherford, TX 76087 - Phone
- (817) 552-8263
- Fax
- (817) 441-1916
- NPI assigned
- Jun 11, 2009
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 35290 | TX | Primary |
Addresses
Primary practice location
109 Manor Court N. Willow Park
Weatherford, TX 76087
Mailing address
109 Manor Court N. Willow Park
Weatherford, TX 76087
Phone (817) 552-8263
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
| License | State | Type | Specialty |
|---|---|---|---|
| 35290 | TX | MD | Speech-Language Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Senior Mental Health Solutions, LP | Clinical | Past | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244678400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1244678400000",
"number": "1093942567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 MANOR COURT N. WILLOW PARK",
"city": "WEATHERFORD",
"state": "TX",
"postal_code": "76087",
"telephone_number": "817-552-8263",
"fax_number": "817-441-1916"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 MANOR COURT N. WILLOW PARK",
"city": "WEATHERFORD",
"state": "TX",
"postal_code": "76087",
"telephone_number": "817-552-8263",
"fax_number": "817-441-1916"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIEMAN",
"first_name": "ELIZABETH",
"middle_name": "GUENEVERE",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-11",
"last_updated": "2009-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "35290",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Weatherford, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.