Jane Harakal Phillips, PH.D, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34663 Issued in TX

Practice address

4150 International PLZ
Fort Worth, TX 76109-4892

Phone

(682) 225-6990

Fax

(817) 860-4082

NPI assigned

Dec 9, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Jane Phillips, PHD, LCSW & Associates, PLLC

  • Clinical Social Worker
  • Fort Worth, TX
  • NPI 1265817043
  NPD (past) Authorized official

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

{
    "created_epoch": "1165622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372032000000",
    "number": "1164582433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3909 PALUXY HWY",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760485538",
            "telephone_number": "682-225-6990",
            "fax_number": "817-860-4082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 INTERNATIONAL PLZ",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094892",
            "telephone_number": "682-225-6990",
            "fax_number": "817-860-4082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "JANE",
        "middle_name": "HARAKAL",
        "name_prefix": "Dr.",
        "credential": "PH.D, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-09",
        "last_updated": "2013-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "34663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1752982",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donald G Phillips, D.O.
• Eleanor Hoppe Phillips, FNP
• Erin Phillips, M.S., CCC-SLP
• Gregory Joseph Phillips, MD
• Jalene W Phillips, JALENE PHILLIPS
• Katey Zelle Phillips, DNP, CRNA
• Leslie Anne Phillips, MD
• Leslie Marie Phillips, RN
• Megan D Phillips, RN
• Michael Stephen Phillips, M.D.

• Clinical Social Worker in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2013; 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.