Individual provider Active NPI

Jay Kirklyn Sawyers

  • Professional Counselor
  • Fort Worth, TX
National Provider Identifier
1174221618
Registry record updated Feb 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
69584 Issued in TX
Practice address
5025 Keating St
Fort Worth, TX 76244-6163
Phone
(903) 818-4480
NPI assigned
Feb 22, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 69584 TX Primary

Addresses

Primary practice location

5025 Keating St
Fort Worth, TX 76244-6163

Mailing address

5025 Keating St
Fort Worth, TX 76244-6163
Phone (903) 818-4480

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
I20240214000980 TX Practitioner - Mental Health Counselor 9234573692 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Invicta Healthcare PLLCGroup PAC ID 5698016301, 7 clinicians

Practice addresses (Care Compare)

9545 N Beach St
Suite 101
Fort Worth, TX 76244-6470
Phone (817) 381-9650

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Invicta Healthcare PLLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

9545 N Beach St
Ste 101
Fort Worth, TX 76244
Phone (817) 381-9650

191 W Southlake Blvd
Ste 100
Southlake, TX 76092
Phone (817) 381-9650

771 E Southlake Blvd
Ste 101
Southlake, TX 76092
Phone (817) 381-9650

Organizations & group practices 1

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": "1677024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1174221618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5025 KEATING ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762446163",
            "telephone_number": "903-818-4480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5025 KEATING ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762446163",
            "telephone_number": "903-818-4480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAWYERS",
        "first_name": "JAY",
        "middle_name": "KIRKLYN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-02-22",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "69584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.