Individual provider Active NPI

Sophia Winston Eldred, PHD

  • Clinical Child & Adolescent Psychologist
  • Fort Worth, TX
National Provider Identifier
1306565585
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
39421 Issued in TX
Practice address
901 7TH Ave Ste 2100
Fort Worth, TX 76104-2722
Phone
(682) 885-3917
NPI assigned
Aug 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X 39421 TX Primary

Addresses

Primary practice location

901 7TH Ave Ste 2100
Fort Worth, TX 76104-2722

Mailing address

PO Box 99213
Fort Worth, TX 76199-0213
Phone (682) 885-1860

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • 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
I20250321001830 TX Practitioner - Clinical Psychologist 2668994377 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
39421TXMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Cook Children'S Medical Center Clinical Child & Adolescent Current Accepting new patients
Cook Children'S Medical Center CurrentSince Jan 16, 2025 Accepting new patients
Cook Children'S Medical Center CurrentSince Jan 16, 2025 Accepting new patients
Cook Children'S Medical Center Clinical Child & Adolescent CurrentSince Jun 11, 2023 Accepting new patients

Locations

901 7th Ave
Ste 2100
Fort Worth, TX 76104
Phone (682) 885-1480

1500 Cooper St
Ft Worth, TX 76104
Phone (682) 885-2500

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1661212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1306565585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99213",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761990213",
            "telephone_number": "682-885-1860",
            "fax_number": "682-885-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 7TH AVE STE 2100",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042722",
            "telephone_number": "682-885-3917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDRED",
        "first_name": "SOPHIA",
        "middle_name": "WINSTON",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-23",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "TX",
            "license": "39421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.