Individual provider Active NPI

Courtney Landes, LCSW

  • Clinical Social Worker
  • Fort Worth, TX
National Provider Identifier
1437514320
Registry record updated Dec 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
55253 Issued in TX
Practice address
3200 Sanguinet St
Fort Worth, TX 76107-5355
Phone
(817) 255-2652
Fax
(817) 255-2657
NPI assigned
Dec 21, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 55253 TX Primary

Addresses

Primary practice location

3200 Sanguinet St
Fort Worth, TX 76107-5355

Mailing address

3200 Sanguinet St
Fort Worth, TX 76107-5355
Phone (817) 255-2652

Other names 1

  • Courtney Siegel 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
I20240426001062 TX Practitioner - Clinical Social Worker 1557701349 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
55253TXMDAmbulatory Care Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Lena Pope Home, Inc. Clinical CurrentSince Apr 11, 2024 Accepting new patients

Locations

3200 Sanguinet St
Fort Worth, TX 76107
Phone (817) 255-2500

Organizations & group practices 1

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": "1450656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450656000000",
    "number": "1437514320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 SANGUINET ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761075355",
            "telephone_number": "817-255-2652",
            "fax_number": "817-255-2657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 SANGUINET ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761075355",
            "telephone_number": "817-255-2652",
            "fax_number": "817-255-2657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDES",
        "first_name": "COURTNEY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-21",
        "last_updated": "2015-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "55253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "SIEGEL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.