Active NPI
Kaitlin Stone, LCSW
- Clinical Social Worker
- Fort Worth, TX
National Provider Identifier
1225812928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 54961
- Practice address
- 5608 Malvey Ave Ste 104
Fort Worth, TX 76107-5107 - Phone
- (214) 697-2855
- NPI assigned
- Aug 23, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 54961 | TX | Primary |
Addresses
Primary practice location
5608 Malvey Ave Ste 104
Fort Worth, TX 76107-5107
Mailing address
6930 Briarwood Dr
Fort Worth, TX 76132-3050
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 1, 2024 through Mar 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 54961 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693958400000",
"number": "1225812928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6930 BRIARWOOD DR",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761323050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5608 MALVEY AVE STE 104",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761075107",
"telephone_number": "214-697-2855"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STONE",
"first_name": "KAITLIN",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-08-23",
"last_updated": "2023-09-06",
"certification_date": "2023-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "54961",
"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 Sep 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.