Individual provider Active NPI

Tancy Clarissa Horn-Johnson

  • Clinical Social Worker
  • Waco, TX
National Provider Identifier
1316465628
Registry record updated Dec 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
30027 Issued in TX
Practice address
201 Old Hewitt Rd
Waco, TX 76712-3542
Phone
(254) 239-0784
NPI assigned
Sep 7, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 30027 TX
School Social Worker 1041S0200X 30027 TX
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 30027 TX Primary

Addresses

Primary practice location

201 Old Hewitt Rd
Waco, TX 76712-3542

Mailing address

201 Old Hewitt Rd
Waco, TX 76712-3542
Phone (254) 239-0784

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
I20180306000415 TX Practitioner - Clinical Social Worker 1557622685 Practice locations: Waco, TX

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

201 Old Hewitt Rd
Suite C
Waco, TX 76712-3548
Phone (254) 239-0784

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30027TXMDSchool Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1504742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513814400000",
    "number": "1316465628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 OLD HEWITT RD",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767123542",
            "telephone_number": "254-239-0784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 OLD HEWITT RD",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767123542",
            "telephone_number": "254-239-0784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORN-JOHNSON",
        "first_name": "TANCY",
        "middle_name": "CLARISSA",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-07",
        "last_updated": "2017-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TX",
            "license": "30027",
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "TX",
            "license": "30027",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "30027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.