Individual provider Active NPI

Jacquelyn A Hafford, LCSW-S

  • Clinical Social Worker
  • Cedar Hill, TX
National Provider Identifier
1174832653
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
38982 Issued in TX
Practice address
610 Uptown Blvd Ste 2000
Cedar Hill, TX 75104-3528
Phone
(817) 383-9157
Fax
(817) 761-5364
NPI assigned
Sep 30, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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 38982 TX Primary

Addresses

Primary practice location

610 Uptown Blvd Ste 2000
Cedar Hill, TX 75104-3528

Mailing address

604 McMackin St
Cedar Hill, TX 75104-6886
Phone (817) 383-9157

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
I20180814000874 TX Practitioner - Clinical Social Worker 0749539468 Practice locations: Cedar Hill, TX

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

610 Uptown Blvd
Suite 2000
Cedar Hill, TX 75104-3528
Phone (817) 223-8521

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1285804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1174832653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 MCMACKIN ST",
            "city": "CEDAR HILL",
            "state": "TX",
            "postal_code": "751046886",
            "telephone_number": "817-383-9157",
            "fax_number": "817-761-5364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 UPTOWN BLVD STE 2000",
            "city": "CEDAR HILL",
            "state": "TX",
            "postal_code": "751043528",
            "telephone_number": "817-383-9157",
            "fax_number": "817-761-5364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAFFORD",
        "first_name": "JACQUELYN",
        "middle_name": "A",
        "credential": "LCSW-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-30",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "38982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Hill, TX

Sources for this page

Verify at the official NPI Registry.