Edoghogho Stacy Edosonmwan, RN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1116542 Issued in TX

Practice address

1428 E Arlington Ave
Fort Worth, TX 76104-6124

Phone

(469) 442-9930

NPI assigned

Mar 1, 2019

Last updated

Sep 3, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in LA, TX2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Dallas County Mental Health and Mental Retardation CenterGroup PAC ID 2062308091, 68 clinicians

Nasa Psychiatric Care LLCGroup PAC ID 3779097571, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24614/brand/1/csg/1/fhir/r4

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

• Dallas County Mental Health & Mental Retardation Center

  dba Metrocare Services

  • Psychiatry Physician
  • Dallas, TX
  • NPI 1023239886
  Medicare reassignment Care Compare group NPD
• Nasa Psychiatric Care LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Fort Worth, TX
  • NPI 1508652140
  Medicare reassignment Care Compare group NPD
• Progressive Pathways Psychiatry PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Fort Worth, TX
  • NPI 1285479238
  Medicare reassignment NPD Authorized official
• Swla Center for Health Services

  • Federally Qualified Health Center (FQHC)
  • Lake Charles, LA
  • NPI 1720014186
  Medicare reassignment NPD
• Nasa Healthcare Services LLC

  • Family Medicine Physician
  • Fort Worth, TX
  • NPI 1982287942
  NPD
• Swla Center for Health Services

  • Obstetrics & Gynecology Physician
  • Lake Charles, LA
  • NPI 1255000675
  NPD
• Swla Center for Health Services

  • Pediatrics Physician
  • Lafayette, LA
  • NPI 1366111791
  NPD
• Swla Center for Health Services

  • Federally Qualified Health Center (FQHC)
  • Lafayette, LA
  • NPI 1376725952
  NPD (past)
• Swla Center for Health Services

  • Federally Qualified Health Center (FQHC)
  • Oberlin, LA
  • NPI 1942645007
  NPD (past)

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

{
    "created_epoch": "1551398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1356808901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1428 E ARLINGTON AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761046124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1428 E ARLINGTON AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761046124",
            "telephone_number": "469-442-9930"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 Amanda Ln Ste 100",
            "address_purpose": "LOCATION",
            "city": "Waxahachie",
            "state": "TX",
            "postal_code": "751651391",
            "country_code": "US",
            "telephone_number": "469-523-2646",
            "fax_number": "469-242-9599",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDOSONMWAN",
        "first_name": "EDOGHOGHO",
        "middle_name": "STACY",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-01",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "LA",
            "license": "230297",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1116542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Diane Edley, MS CCC SLP
• Karoline Monet Edmonds, APRN, CRNA
• Steven Ray Edmondson, MD
• Kristy Kay Edney, RN
• Elise Edoka, MD
• Educare Community Living Corporation - Texas (All Ways Caring HomeCare)
• Educare Community Living Corporation - Texas (All Ways Caring HomeCare)
• Educare Community Living Corporation - Texas (All Ways Caring HomeCare)
• Educare Community Living Corporation - Texas (All Ways Caring HomeCare)
• Educare Community Living Corporation - Texas (All Ways Caring HomeCare)

• Psychiatric/Mental Health Nurse Practitioner in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.