Shana Leigh Hazzard, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

32847 Issued in TX

Practice address

3800 Hulen St
Fort Worth, TX 76107-7276

Phone

(817) 255-2612

Fax

(817) 735-4926

NPI assigned

Aug 25, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1219622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219622400000",
    "number": "1407003197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 SANGUINET ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761075336",
            "telephone_number": "817-255-2612",
            "fax_number": "817-735-4926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 HULEN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761077276",
            "telephone_number": "817-255-2612",
            "fax_number": "817-735-4926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZZARD",
        "first_name": "SHANA",
        "middle_name": "LEIGH",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-25",
        "last_updated": "2008-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "32847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS STATE BOARD OF SOCIAL WORK EXAMINERS",
            "identifier": "32847",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tamara L. Hayward, M.D.
• Kevin L Haywood Sr., RDA
• Derek Hazelwood
• Richard W Hazen, M.D.
• Kaitlyn Hazlewood, MS, CCC-SLP
• HB Health PLLC
• HBCS Enterprises LLC
• Hcsvs Mental Health Telemedicine Startup PBC
• HDC Podiatry, LLC
• Timothy Alan Head, D.O.

• Clinical Social Worker in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.