Individual provider Active NPI

Debra Pinson Mattocks, LCSW

  • Clinical Social Worker
  • Fort Worth, TX
National Provider Identifier
1346307857
Registry record updated Nov 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
33494 Issued in TX
Practice address
6012 Reef Point LN Ste C
Fort Worth, TX 76135-2056
Phone
(682) 312-8184
Fax
(817) 238-1232
NPI assigned
Jan 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2024

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 33494 TX Primary

Addresses

Primary practice location

6012 Reef Point LN Ste C
Fort Worth, TX 76135-2056

Mailing address

6012 Reef Point LN Ste C
Fort Worth, TX 76135-2056
Phone (682) 312-8184

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
I20070504000317 TX Practitioner - Clinical Social Worker 6204932411 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6012 Reef Point LN
Suite C
Fort Worth, TX 76135-2056
Phone (682) 312-8184

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3725OKMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Journey Behavioral Health Center PLLC CurrentSince Dec 3, 2023 Accepting new patients

Locations

6012 Reef Point Ln
Ste C
Fort Worth, TX 76135
Phone (682) 312-8184

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732838400000",
    "number": "1346307857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6012 REEF POINT LN STE C",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761352056",
            "telephone_number": "682-312-8184",
            "fax_number": "817-238-1232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6012 REEF POINT LN STE C",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761352056",
            "telephone_number": "682-312-8184",
            "fax_number": "817-238-1232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTOCKS",
        "first_name": "DEBRA",
        "middle_name": "PINSON",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2024-11-29",
        "certification_date": "2024-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "33494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.