Individual provider Active NPI

Tisha Wynette Calhoun, LCSW

  • Clinical Social Worker
  • Fort Worth, TX
National Provider Identifier
1174781272
Registry record updated May 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
25776 Issued in TX
Practice address
2309 Whispering CT
Fort Worth, TX 76133-4420
Phone
(817) 370-9231
Fax
(817) 370-9231
NPI assigned
May 27, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2008

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 25776 TX Primary

Addresses

Primary practice location

2309 Whispering CT
Fort Worth, TX 76133-4420

Mailing address

2309 Whispering CT
Fort Worth, TX 76133-4420
Phone (817) 370-9231

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
I20080728000231 TX Practitioner - Clinical Social Worker 9537232319 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25776TXMDClinical Social Worker

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": "1211846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211846400000",
    "number": "1174781272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2309 WHISPERING CT",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761334420",
            "telephone_number": "817-370-9231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2309 WHISPERING CT",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761334420",
            "telephone_number": "817-370-9231",
            "fax_number": "817-370-9231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALHOUN",
        "first_name": "TISHA",
        "middle_name": "WYNETTE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-27",
        "last_updated": "2008-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "25776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.