Active NPI
Shannon Thomas, LCSW
- Clinical Social Worker
- Southlake, TX
National Provider Identifier
1124262373
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 50325
- Practice address
- 1560 E Southlake Blvd Ste 100
Southlake, TX 76092-6462 - Phone
- (817) 897-8882
- Fax
- (817) 953-8900
- NPI assigned
- Apr 30, 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 | 50325 | TX | Primary |
Addresses
Primary practice location
1560 E Southlake Blvd Ste 100
Southlake, TX 76092-6462
Mailing address
1560 E Southlake Blvd Ste 100
Southlake, TX 76092-6462
Phone (817) 897-8882
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 29, 2023 through Dec 29, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50325 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1241049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1763424000000",
"number": "1124262373",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1560 E SOUTHLAKE BLVD STE 100",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760926462",
"telephone_number": "817-897-8882",
"fax_number": "817-953-8900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1560 E SOUTHLAKE BLVD STE 100",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760926462",
"telephone_number": "817-897-8882",
"fax_number": "817-953-8900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "SHANNON",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-04-30",
"last_updated": "2025-11-18",
"certification_date": "2025-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "50325",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southlake, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.