Individual provider Active NPI

Jackie Nell Bryant, LMSW

  • Social Worker
  • Dallas, TX
National Provider Identifier
1396520094
Registry record updated Oct 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
67646 Issued in TX
Practice address
4925 Greenville Ave Ste 1050
Dallas, TX 75206-4084
Phone
(214) 918-1999
NPI assigned
Aug 30, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 67646 TX Primary

Addresses

Primary practice location

4925 Greenville Ave Ste 1050
Dallas, TX 75206-4084

Mailing address

4925 Greenville Ave Ste 1050
Dallas, TX 75206-4084
Phone (214) 918-1999

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
I20250717000667 TX Practitioner - Mental Health Counselor 3375058308

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1693353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1396520094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4925 GREENVILLE AVE STE 1050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752064084",
            "telephone_number": "214-918-1999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4925 GREENVILLE AVE STE 1050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752064084",
            "telephone_number": "214-918-1999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "JACKIE",
        "middle_name": "NELL",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-30",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TX",
            "license": "67646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.