Individual provider Active NPI

Jocelyn Marie Hicks, LCSW

  • Clinical Social Worker
  • Dallas, TX
National Provider Identifier
1396276234
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
56310 Issued in TX
Practice address
2335 Marfa Ave
Dallas, TX 75216-5748
Phone
(972) 992-8389
NPI assigned
Mar 22, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X L12110 OR
Clinical Social Worker 1041C0700X 56310 TX Primary

Addresses

Primary practice location

2335 Marfa Ave
Dallas, TX 75216-5748

Mailing address

2335 Marfa Ave
Dallas, TX 75216
Phone (972) 992-8389

Other identifiers 1

IdentifierTypeStateIssuer
4255101-01MedicaidTX

Other names 1

  • Jocelyn Marie Mitchell Former name

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
I20210708000542 TX Practitioner - Clinical Social Worker 0446652879 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2922 Martin Luther King Jr Blvd
Dallas, TX 75215-2321
Phone (214) 426-5645

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L12110ORMDClinical Social Worker
56310TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Martin Luther King Jr Family Clinic CurrentSince Oct 19, 2024 Accepting new patients
Dallas County Mental Health & Mental Retardation Center PastSince Oct 19, 2024 Accepting new patients

Locations

2922 Mlk Blvd
#B
Dallas, TX 75215
Phone (214) 425-3645

2922 Martin Luther King Jr Blvd
Dallas, TX 75215
Phone (214) 426-3645

Interoperability endpoints

  • Direct secure messaging: jocelyn.hicks.1@17390.direct.athenahealth.com

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": "1490140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1396276234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2335 MARFA AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75216",
            "telephone_number": "972-992-8389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2335 MARFA AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752165748",
            "telephone_number": "972-992-8389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "JOCELYN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-22",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L12110",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "56310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4255101-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOCELYN",
            "last_name": "MITCHELL",
            "middle_name": "MARIE",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.