Active NPI
Mayara Mercado Coulter, LCSW
- Clinical Social Worker
- Fort Worth, TX
National Provider Identifier
1306004767
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 61840
- Practice address
- 200 Hensley Ave
Fort Worth, TX 76127 - Phone
- (817) 852-3597
- NPI assigned
- Jun 1, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW23762 | FL | |
| Clinical Social Worker | 1041C0700X | 007384 | CT | |
| Clinical Social Worker | 1041C0700X | 61840 | TX | Primary |
Addresses
Primary practice location
200 Hensley Ave
Fort Worth, TX 76127
Mailing address
200 Hensley Ave
Fort Worth, TX 76127
Phone (817) 852-3597
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 |
|---|---|---|---|
| 61840 | TX | MD | Professional Counselor |
| SW23762 | FL | MD | Clinical Social Worker |
| 007384 | CT | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1763510400000",
"number": "1306004767",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 HENSLEY AVE",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "76127",
"telephone_number": "817-852-3597"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 HENSLEY AVE",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "76127",
"telephone_number": "817-852-3597"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COULTER",
"first_name": "MAYARA",
"middle_name": "MERCADO",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-01",
"last_updated": "2025-11-19",
"certification_date": "2025-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW23762",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "007384",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "61840",
"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 Nov 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.