Aurelio De la Fuente Jr., LCSW

Individual provider Active NPI Clinical Social Worker · Allen, TX

NPI 1366801722 · NPPES record last updated Apr 6, 2023

Key facts

NPI
1366801722
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
61487 (TX)
Practice address
400 N Allen Dr Ste 204
Allen, TX 75013-2568
Phone
(972) 233-1010
Fax
(214) 623-6692
NPI assigned
Feb 15, 2016
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Assurasource LTD (61 clinicians)

Practice addresses (Care Compare)

400 N Allen Dr
Suite 204
Allen, TX 75013-2568
Phone (972) 233-1010

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20230418001063 TX Practitioner - Clinical Social Worker 6103291505 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
61487TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Assurasource LTD Clinical Current
since Apr 1, 2023
Accepting new patients

Locations

400 N Allen Dr
Ste 204
Allen, TX 75013

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 61487 TX
Clinical Social Worker
Group: 193200000X MULTI-SPECIALTY GROUP
1041C0700X 61487 TX Yes

Addresses

Primary practice location

400 N Allen Dr Ste 204
Allen, TX 75013-2568

Mailing address

1814 Bahamas Dr
Number 2
Edinburg, TX 78541
Phone (956) 414-3996

Other practice location 1

1814 Bahamas Dr
Number 2
Edinburg, TX 78541-3991
Phone (956) 414-3996

Other providers in Allen, TX

All providers in Allen, TX · Clinical Social Worker in Texas

Sources for this page

Verify at the official NPI Registry.