Individual provider Active NPI

Deborah Kay Ignacio, LCSW

  • Clinical Social Worker
  • Mineral Wells, TX
National Provider Identifier
1164749529
Registry record updated Apr 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
16373 Issued in TX
Practice address
3141 FM 2256
Mineral Wells, TX 76067-1011
Phone
(817) 454-8882
NPI assigned
Apr 26, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2010

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 16373 TX Primary

Addresses

Primary practice location

3141 FM 2256
Mineral Wells, TX 76067-1011

Mailing address

3141 FM 2256
Mineral Wells, TX 76067-1011
Phone (817) 454-8882

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
I20110408000288 TX Practitioner - Clinical Social Worker 0143404517 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16373TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Supportive Care LLC CurrentSince Jun 5, 2016 Accepting new patients
Suzanne M. Guynes, M.D.P.a. CurrentSince Nov 3, 2016 Accepting new patients

Locations

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

825 W Kearney St
Mesquite, TX 75149
Phone (972) 288-7660

115 E Lee Ave
Weatherford, TX 76086
Phone (817) 637-4358

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": "1272240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272240000000",
    "number": "1164749529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3141 FM 2256",
            "city": "MINERAL WELLS",
            "state": "TX",
            "postal_code": "760671011",
            "telephone_number": "817-454-8882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3141 FM 2256",
            "city": "MINERAL WELLS",
            "state": "TX",
            "postal_code": "760671011",
            "telephone_number": "817-454-8882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IGNACIO",
        "first_name": "DEBORAH",
        "middle_name": "KAY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-26",
        "last_updated": "2010-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "16373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mineral Wells, TX

Sources for this page

Verify at the official NPI Registry.