Individual provider Active NPI

Ashten Marie Wiedebusch, LMSW

  • Clinical Social Worker
  • Weatherford, TX
National Provider Identifier
1124900782
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
109263 Issued in TX
Practice address
114 N Waco St
Weatherford, TX 76086-3232
Phone
(817) 594-3052
NPI assigned
Jul 24, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 109263 TX Primary
Social Worker 104100000X 109263 TX

Addresses

Primary practice location

114 N Waco St
Weatherford, TX 76086-3232

Mailing address

174 College Park Dr Apt 165
Weatherford, TX 76086-6494
Phone (940) 507-0807

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250818001422 TX Practitioner - Clinical Social Worker 4688173610 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2101 W Pearl St
Granbury, TX 76048-1894

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pecan Valley MHMR Region CurrentSince Aug 4, 2025 Accepting new patients
Pecan Valley MHMR Region Clinical CurrentSince Aug 4, 2025 Accepting new patients

Locations

2101 W Pearl St
Granbury, TX 76048
Phone (817) 579-4400

906 W Lingleville Rd
Stephenville, TX 76401
Phone (254) 968-4181

1715 Santa Fe Dr
Weatherford, TX 76086
Phone (817) 579-4400

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": "1753315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1124900782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 COLLEGE PARK DR APT 165",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760866494",
            "telephone_number": "940-507-0807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 N WACO ST",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760863232",
            "telephone_number": "817-594-3052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEDEBUSCH",
        "first_name": "ASHTEN",
        "middle_name": "MARIE",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-24",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "109263",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TX",
            "license": "109263",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weatherford, TX

Sources for this page

Verify at the official NPI Registry.