Individual provider Active NPI

Kassi Leann Lightfoot, LCSW

  • Clinical Social Worker
  • Sherman, TX
National Provider Identifier
1225790389
Registry record updated Oct 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
65252 Issued in TX
Practice address
1042 S Idlewild Dr
Sherman, TX 75090-8326
Phone
(903) 227-2418
NPI assigned
Oct 6, 2021
Last updated
Oct 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2021

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 65252 TX Primary

Addresses

Primary practice location

1042 S Idlewild Dr
Sherman, TX 75090-8326

Mailing address

1042 S Idlewild Dr
Sherman, TX 75090-8326
Phone (903) 227-2418

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: No
  • 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
I20250423003791 TX Order and Referring Only - Clinical Social Worker 3678099595

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
65252TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mending Roots Therapy CurrentSince May 21, 2023 Accepting new patients
McKinney Foundations Counseling Past Accepting new patients

Locations

1800 Teague Dr
Ste 223
Sherman, TX 75090
Phone (903) 269-9107

Organizations & group practices 2

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": "1633478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1225790389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1042 S IDLEWILD DR",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "750908326",
            "telephone_number": "903-227-2418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1042 S IDLEWILD DR",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "750908326",
            "telephone_number": "903-227-2418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIGHTFOOT",
        "first_name": "KASSI",
        "middle_name": "LEANN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-06",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "65252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman, TX

Sources for this page

Verify at the official NPI Registry.