Active NPI
Robert Jacob Fortingo, LCSW
- Clinical Social Worker
- Houston, TX
National Provider Identifier
1417308529
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 60754
- Practice address
- 2800 S Macgregor Way
Houston, TX 77021 - Phone
- (832) 940-2941
- NPI assigned
- Jun 29, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 60754 | TX | Primary |
Addresses
Primary practice location
2800 S Macgregor Way
Houston, TX 77021
Mailing address
2800 S Macgregor Way
Houston, TX 77021-1032
Phone (832) 940-2941
Other practice location 1
5901 Long Dr
Houston, TX 77087-1003
Phone (713) 970-7000
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1467158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531440000000",
"number": "1417308529",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2800 S MACGREGOR WAY",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770211032",
"telephone_number": "832-940-2941"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2800 S MACGREGOR WAY",
"city": "HOUSTON",
"state": "TX",
"postal_code": "77021",
"telephone_number": "832-940-2941"
}
],
"practiceLocations": [
{
"address_1": "5901 Long Dr",
"address_purpose": "LOCATION",
"city": "Houston",
"state": "TX",
"postal_code": "770871003",
"country_code": "US",
"telephone_number": "713-970-7000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FORTINGO",
"first_name": "ROBERT JACOB",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-06-29",
"last_updated": "2018-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "60754",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.