Individual provider Active NPI

Ange Kay Fontenot, LCSW

  • Clinical Social Worker
  • Waxahachie, TX
National Provider Identifier
1154572030
Registry record updated May 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
38707 Issued in TX
Practice address
209 E Main St Ste 112
Waxahachie, TX 75165
Phone
(214) 995-9566
NPI assigned
Oct 9, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2018

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 38707 TX Primary

Addresses

Primary practice location

209 E Main St Ste 112
Waxahachie, TX 75165

Mailing address

209 E Main St Ste 112
Waxahachie, TX 75165-3755
Phone (214) 995-9566

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
38707TXMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1223510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527120000000",
    "number": "1154572030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 E MAIN ST STE 112",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751653755",
            "telephone_number": "214-995-9566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 E MAIN ST STE 112",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "75165",
            "telephone_number": "214-995-9566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTENOT",
        "first_name": "ANGE",
        "middle_name": "KAY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-09",
        "last_updated": "2018-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "38707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waxahachie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2018; 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.