Active NPI
Celena D Fannin, LCSW
- Clinical Social Worker
- Fort Worth, TX
National Provider Identifier
1407640816
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 61959
- Practice address
- 3612 Wren Ave
Fort Worth, TX 76133-2131 - Phone
- (817) 718-8366
- NPI assigned
- Apr 9, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 61959 | TX | |
| Case Manager/Care Coordinator | 171M00000X | 61959 | TX | |
| Clinical Social Worker | 1041C0700X | 61959 | TX | Primary |
Addresses
Primary practice location
3612 Wren Ave
Fort Worth, TX 76133-2131
Mailing address
3612 Wren Ave
Fort Worth, TX 76133-2131
Phone (817) 718-8366
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61959 | TX | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1744156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753401600000",
"number": "1407640816",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3612 WREN AVE",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761332131",
"telephone_number": "817-718-8366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3612 WREN AVE",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761332131",
"telephone_number": "817-718-8366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FANNIN",
"first_name": "CELENA",
"middle_name": "D",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-04-09",
"last_updated": "2025-07-25",
"certification_date": "2025-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "61959",
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "TX",
"license": "61959",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "61959",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
- Felix Fang, MD
- Lori Fangue
- Karin Sophie Fanley
- Fannin County Hospital Authority (Arlington Heights Health and Rehabilitation Center)
- Fannin County Hospital Authority (Downtown Health and Rehabilitation Center)
- Jenny Ruth Fanning, CRNA
- Rachel Marie Fanous, CNM
- James Fant, DC
- Marian Farag, DPT
- Fahmi Jasmin Farah, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.