Jan L Birks, CLINICAL SOCIAL WORK

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

66781 Issued in TX

Practice address

2025 Langston St
Fort Worth, TX 76105-3622

Phone

(817) 770-6937

NPI assigned

Aug 6, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• The Gift Enterprises

  • Clinical Social Worker
  • Fort Worth, TX
  • NPI 1063879161
  Medicare reassignment

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

{
    "created_epoch": "1533513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1194203695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 LANGSTON ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761053622",
            "telephone_number": "817-770-6937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 LANGSTON ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761053622",
            "telephone_number": "817-770-6937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRKS",
        "first_name": "JAN",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "CLINICAL SOCIAL WORK",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-06",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "12651",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "66781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Micheal Birdow
• Frank Nance Birdsell, MD
• Birdville Isd
• Barbara A Birdwell, MD
• Samuel D Birkner, ED.D., L.P.C.
• Brian D. Birmingham, CRNA
• Birth Fletcher Oral Surgery Keller
• Birth Stewart Oral Surgery Ft Worth
• Sheila T Birth, D.D.S. M.S.
• Brittany Bisetti

• Clinical Social Worker in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.