Individual provider Active NPI

Sherald G. Anderson-Vogt, LCSW

  • Clinical Social Worker
  • Fort Worth, TX
National Provider Identifier
1538309802
Registry record updated Jun 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
31278 Issued in TX
Practice address
1160 Country Club LN
Fort Worth, TX 76112-2303
Phone
(817) 496-9796
Fax
(817) 451-4104
NPI assigned
Feb 26, 2009
Last updated
Jun 24, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2010

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 31278 TX Primary

Addresses

Primary practice location

1160 Country Club LN
Fort Worth, TX 76112-2303

Mailing address

2315 Smokerise Dr
Arlington, TX 76016-1237
Phone (817) 247-2623

Other identifiers 1

IdentifierTypeStateIssuer
199967401MedicaidTX

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

State licenses

LicenseStateTypeSpecialty
31278TXMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1235606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277337600000",
    "number": "1538309802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 SMOKERISE DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760161237",
            "telephone_number": "817-247-2623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 COUNTRY CLUB LN",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761122303",
            "telephone_number": "817-496-9796",
            "fax_number": "817-451-4104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON-VOGT",
        "first_name": "SHERALD",
        "middle_name": "G.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-26",
        "last_updated": "2010-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "31278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "199967401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.