Individual provider Active NPI

Jennifer O'Banon, LMSW

  • Clinical Social Worker
  • Wylie, TX
National Provider Identifier
1174479232
Registry record updated Mar 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
118348 Issued in TX
Practice address
303 S Highway 78 Ste 103
Wylie, TX 75098-3971
Phone
(469) 342-3468
NPI assigned
Mar 10, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2026

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 118348 TX Primary

Addresses

Primary practice location

303 S Highway 78 Ste 103
Wylie, TX 75098-3971

Mailing address

303 S Highway 78 Ste 103
Wylie, TX 75098-3971
Phone (469) 342-3468

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
118348TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
CCNT Inc. Clinical PastSince Sep 5, 2024 Accepting new patients

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": "1773100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773100800000",
    "number": "1174479232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 S HIGHWAY 78 STE 103",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750983971",
            "telephone_number": "469-342-3468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 S HIGHWAY 78 STE 103",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750983971",
            "telephone_number": "469-342-3468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BANON",
        "first_name": "JENNIFER",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-03-10",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "118348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wylie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2026; 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.