Individual provider Active NPI

Damaris Sarahy Mosharaf, LCSW

  • Clinical Social Worker
  • Fort Worth, TX
National Provider Identifier
1134519234
Registry record updated Jan 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
56168 Issued in TX
Practice address
2106 N Main St
Fort Worth, TX 76164-8511
Phone
(817) 625-4254
Fax
(512) 291-5657
NPI assigned
Jan 27, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2015

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 56168 TX Primary

Addresses

Primary practice location

2106 N Main St
Fort Worth, TX 76164-8511

Mailing address

2106 N Main St
Fort Worth, TX 76164-8511
Phone (817) 625-4254

Other identifiers 1

IdentifierTypeStateIssuer
56168OtherTXLICENSE

Other names 1

  • Damaris Saray Lopez-Mosharaf Former name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
56168TXMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1422316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422316800000",
    "number": "1134519234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2106 N MAIN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761648511",
            "telephone_number": "817-625-4254",
            "fax_number": "512-291-5657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 N MAIN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761648511",
            "telephone_number": "817-625-4254",
            "fax_number": "512-291-5657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSHARAF",
        "first_name": "DAMARIS",
        "middle_name": "SARAHY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-27",
        "last_updated": "2015-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "56168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "56168",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAMARIS",
            "last_name": "LOPEZ-MOSHARAF",
            "middle_name": "SARAY",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Jan 27, 2015; 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.