Active NPI
Jason M McCoy, LCSW
- Clinical Social Worker
- Fort Worth, TX
National Provider Identifier
1215164835
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 55930
- Practice address
- 3629 Western Center Blvd
Ste. 211
Fort Worth, TX 76137-1939 - Phone
- (817) 232-9400
- NPI assigned
- Jun 22, 2009
- Last updated
- Dec 8, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 007307 | IA | |
| Clinical Social Worker | 1041C0700X | 55930 | TX | Primary |
Addresses
Primary practice location
3629 Western Center Blvd
Ste. 211
Fort Worth, TX 76137-1939
Mailing address
3629 Western Center Blvd
Ste. 211
Fort Worth, TX 76137-1939
Phone (469) 999-3208
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
| License | State | Type | Specialty |
|---|---|---|---|
| 007307 | IA | MD | Social Worker |
| 55930 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rhonda M. Johnson PHD. PLLC | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Center for Counseling & Family Relationships
- Professional Counselor
- Fort Worth, TX
- NPI 1700057114
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323302400000",
"number": "1215164835",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3629 WESTERN CENTER BLVD",
"address_2": "STE. 211",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761371939",
"telephone_number": "469-999-3208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3629 WESTERN CENTER BLVD",
"address_2": "STE. 211",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761371939",
"telephone_number": "817-232-9400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCOY",
"first_name": "JASON",
"middle_name": "M",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-06-22",
"last_updated": "2011-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IA",
"license": "007307",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "55930",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.