Individual provider Active NPI

Dudley T Farenthold, LCDC LPC LCSW

  • Clinical Social Worker
  • Houston, TX
National Provider Identifier
1225193261
Registry record updated Mar 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW 23834 Issued in TX
Practice address
5331 W Orem Dr
Houston, TX 77045-5036
Phone
(713) 433-0528
Fax
(832) 539-1299
NPI assigned
Dec 27, 2006
Last updated
Mar 3, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X 23834 LCSW TX
Professional Counselor 101YP2500X 14943 TX
Clinical Social Worker 1041C0700X LCSW 23834 TX Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCDC 797 TX

Addresses

Primary practice location

5331 W Orem Dr
Houston, TX 77045-5036

Mailing address

PO Box 451485
Houston, TX 77245-1485
Phone (713) 433-0528

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCDC 797TXMDAddiction (Substance Use Disorder) Counselor
LCSW 23834TXMDClinical Social Worker
23834TXMDDentist
23834 LCSWTXMDCase Manager/Care Coordinator

Practice roles

OrganizationSpecialtyStatusNew patients
Helping Hearts and Hands Addiction (Substance Use Disorder) 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.

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393804800000",
    "number": "1225193261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 451485",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772451485",
            "telephone_number": "713-433-0528",
            "fax_number": "832-539-1299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5331 W OREM DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770455036",
            "telephone_number": "713-433-0528",
            "fax_number": "832-539-1299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARENTHOLD",
        "first_name": "DUDLEY",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "LCDC LPC LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2014-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "TX",
            "license": "23834 LCSW",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "14943",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "LCSW 23834",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "LCDC 797",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2014; 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.