Active NPI
Elizabeth Angelina Reyes, LCSW
- Clinical Social Worker
- Fort Worth, TX
National Provider Identifier
1356480693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 29768
- Practice address
- 1424 Summit Ave
Fort Worth, TX 76102-5912 - Phone
- (817) 335-4041
- Fax
- (817) 335-4043
- NPI assigned
- Feb 5, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 29768 | TX | Primary |
Addresses
Primary practice location
1424 Summit Ave
Fort Worth, TX 76102-5912
Mailing address
3214 Greene Ave
Fort Worth, TX 76109-2320
Phone (817) 714-0939
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 |
|---|---|---|---|
| 29768 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1356480693",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3214 GREENE AVE",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761092320",
"telephone_number": "817-714-0939",
"fax_number": "817-335-4043"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1424 SUMMIT AVE",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761025912",
"telephone_number": "817-335-4041",
"fax_number": "817-335-4043"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYES",
"first_name": "ELIZABETH",
"middle_name": "ANGELINA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-05",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "29768",
"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 Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.