Angelica Daniel Richard, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

62179 Issued in TX

Practice address

4500 Mercantile Plaza Dr Ste 307
Fort Worth, TX 76137-4230

Phone

(817) 232-9400

Fax

(817) 232-9403

NPI assigned

Jul 12, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 22, 2024 through Feb 22, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Rhonda M. Johnson PHD. PLLC

  • Professional Counselor
  • Fort Worth, TX
  • NPI 1700057114
  NPD (past)

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

{
    "created_epoch": "1657584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1356075832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5408 GRAYSON RIDGE DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761797111",
            "telephone_number": "469-964-5984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 MERCANTILE PLAZA DR STE 307",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761374230",
            "telephone_number": "817-232-9400",
            "fax_number": "817-232-9403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARD",
        "first_name": "ANGELICA",
        "middle_name": "DANIEL",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-12",
        "last_updated": "2024-04-02",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "62179",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "62179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Garcia Rich, PA-C
• Sonya Rich, LCSW
• Richard D Yentis MD Faacp PA
• Richard T. Jones, PLLC
• Richard Thomas Ethridge MD
• Robert C Richard, DO
• Richards Laboratories of Texas
• Charnise Richards
• John A Richards, MD
• Kayann Monique Richards, MS

• Clinical Social Worker in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; 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.

Verify at the official NPI Registry.